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背景与目的多参数流式细胞免疫表型分析可提供有力的技术支持,以提高淋巴增殖性疾病诊断的准确率。我们采用流式细胞仪对121例临床怀疑淋巴瘤患者的135份淋巴结、血液、骨髓和脑脊液标本的免疫表型进行分析,观察其在提高诊断准确率和诊断效率方面的作用。方法所有标本均进行常规形态学、病理学和免疫组化检测,行WHO标准分型;同时对采集的标本制备单个细胞悬液,行多参数流式细胞学检测。比较常规检测和加用流式细胞学免疫表型分析对检测结果的影响。结果①淋巴结常规病理中3例误诊或按照WHO标准无法分型的病例,经流式检测诊断明确。②97例外周血和骨髓标本,FAB分类诊断明确的88例,均按照新的WHO分类标准重新分型;FAB分类中诊断未明的有9例,经流式细胞仪进一步分析,仅有一例按照WHO标准仍未能明确诊断。③脑脊液标本多参数免疫标志,有助于中枢神经系统白血病/淋巴瘤的诊断。结论流式细胞仪免疫表型检测可用于淋巴增殖性疾病的诊断和鉴别诊断,以及微小残留病灶的检测,提高了诊断的准确率。
Background and Objective Multiparametric flow cytometric analysis provides powerful technical support to improve the diagnostic accuracy of lymphoproliferative diseases. We analyzed the immunophenotypes of 135 samples of lymph node, blood, bone marrow and cerebrospinal fluid in 121 patients with clinically suspected lymphoma by flow cytometry, and observed their role in improving diagnostic accuracy and diagnostic efficiency. Methods All the specimens were examined by routine morphological, pathological and immunohistochemical methods and classified according to WHO standard. At the same time, single cell suspensions were collected from the collected specimens for multi-parameter flow cytometry. The effects of routine test and flow cytometry immunophenotyping on test results were compared. Results ① In the routine pathology of lymph nodes, 3 cases were misdiagnosed or could not be typed according to the WHO standard, and were confirmed by flow cytometry. ②97 cases of peripheral blood and bone marrow samples, FAB classification of the diagnosis of a clear 88 cases were classified according to the new WHO classification of re-classification; FAB classification of unknown in 9 cases, further analysis by flow cytometry, only one case according to WHO The standard is still not a clear diagnosis. ③ cerebrospinal fluid samples multiple parameters of immune markers, contribute to the diagnosis of central nervous system leukemia / lymphoma. Conclusion Flow cytometry immuno-phenotype detection can be used for the diagnosis and differential diagnosis of lymphoproliferative diseases, as well as the detection of minimal residual lesions, and improve the diagnostic accuracy.