非霍奇金淋巴瘤骨髓侵犯细胞形态学和免疫表型分析李新星1邓小娟2.docVIP

非霍奇金淋巴瘤骨髓侵犯细胞形态学和免疫表型分析 李新星1 邓小娟2 彭贤贵2 (400061重庆，武警重庆总队医院检验科1；400037重庆，第三军医大学新桥医院血液科2) 　摘要:目的　探讨骨髓细胞形态学和免疫表型在诊断非霍奇金淋巴瘤骨髓浸润中的价值。方法　采用骨髓涂片和流式细胞术联合检测非霍奇金淋巴瘤(NHL)骨髓侵犯。骨髓涂片经瑞氏-吉姆萨液染色,分类计数瘤细胞。骨髓NHL细胞分为4种类型：1.小细胞成熟细胞型；2.大细胞幼稚型；3.大细胞原始型；4.组织细胞型。流式细胞术采用FACS Calibur流式细胞仪， Cellquest软件荧光定量分析。每份标本分析10000个细胞。检测方案采用CD45/SSC设门，重点分析幼稚细胞群及成熟淋巴细胞群，经FSC、SSC、McAb1-FITC、McAb2-PE、CD45-Percp五参数分析，确定免疫表型。结果　38例NHL分别被诊断为B细胞淋巴瘤28例、T细胞淋巴瘤7例、NK细胞淋巴瘤2例,间变性大细胞淋巴瘤1例。38例NHL细胞骨髓侵犯的骨髓细胞形态学分型结果为小细胞成熟型25例（65.8%）、大细胞幼稚型3例（7.9%）、大细胞原始型6例（15.8%）、组织细胞型4例（10.5%）。结论　NHL骨髓侵犯最常见的病理类型是B淋巴细胞瘤（73.7%）。骨髓小细胞成熟细胞型NHL仅见于外周B淋巴细胞肿瘤和外周T淋巴细胞肿瘤，而以外周B淋巴细胞肿瘤最为常见，占92%；小细胞的B细胞肿瘤中，以SLL为主，占52.2%。大细胞原始型的NHL细胞以T细胞和NK细胞淋巴瘤居多（66.7%）。组织细胞型的NHL细胞多见于T细胞淋巴瘤和间变大细胞淋巴瘤，B细胞淋巴瘤少见。应用骨髓细胞形态学和流式细胞术联合检测NHL-BMI，可以提高诊断的准确性并提供相应的病理分型意见。 关键词: 非霍奇金淋巴瘤；骨髓浸润；骨髓细胞形态学；免疫分型；流式细胞术 Analysis of Morphology and Immunophenotype of Bone Marrow Involvement of Non-Hodgkins Lymphoma LI Xin-xing 1 ,DENG Xiao-juan 2 ,PENG Xian-gui2 (1Clinical laboratory ，Chongqing Armed police hospital ，Chongqing 400061，China；2Department of Hematology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037 , China) Abstract: Objective to research the value of morphology and immunophenotype of bone marrow involvement（BMI） of non-Hodgkins lymphoma(NHL) . Methods combined examination of Bone marrow smear and flow cytometry（FCM）are used to detect the BMI of NHL. Bone marrow smears were stained by Wright -Giemsa staining solution and tumor cells of NHL were differentially counted under optical microscope. Cells of NHL were divided into 4 types in bone marrow: 1. small mature lymphoma cells types; 2.large immature lymphoma cells types;3. large primitive lymphoma cells types;4. histiocyte types. Models of FCM is FACS Calibur and Cellquest quantitative analysis software was used. 10,000 cells were tested on each sample. detection scheme included designing CD45/SSC doors and Analyzing importantly the group of immature-cell and mature lymphocyte. The five-parameter analysis