骨髓形态联合血清肿瘤标志物检测对淋巴瘤的诊断及预后意义  

Clinical Significance of Bone Marrow Morphological Examination and Tumor Marker Detection for Lymphoma Diagnosis and Prognosis

作　　者：康慧媛[1] 汪洋[1] 金淑媛[1] 李绵洋[1] 潘玉玲[1] 刘改霞[1] 冯晓倩[1] 王成彬[1] 

机构地区：[1]中国人民解放军总医院临床检验科,北京100853

出　　处：《中国实验血液学杂志》2015年第2期416-419,共4页Journal of Experimental Hematology

基　　金：解放军总医院苗圃基金(12KMM35);国家重大科学仪器设备开发专项项目任务(2012YQ03026107);解放军总医院临床科研扶持基金临床特色优势技术项目(2012FC-TSYS-3051)

摘　　要：目的:本研究拟探讨骨髓形态联合血清肿瘤标志物(tumor marker,TM)检测对淋巴瘤(lymphoma)的诊断及预后意义。方法:对我院2012年1月-2013年10月确诊的47例淋巴瘤患者及20例健康对照标本进行了骨髓细胞形态学检验,同时采用电化学发光法检测多种TM水平,并进行临床参数分析。结果:血清TM特别是CEA、CA125、CA15-3、SF水平在淋巴瘤患者组均高于健康对照组(P=0.029,P=0.000,P=0.005,P=0.000)。淋巴瘤患者组血清TM水平与其一般临床参数并不相关(P>0.05),而与骨髓幼稚淋巴细胞数(或淋巴瘤细胞)、B组症状、分期、IPI预后评分、骨髓是否浸润相关(P<0.05)。淋巴瘤患者中在一般临床参数较均一的情况下,骨髓浸润组较未浸润组B组症状更易见(P=0.031),CA15-3及SF水平升高更多(P=0.002,P=0.000)。结论:骨髓形态联合血清TM水平检测有助于淋巴瘤的诊断、分期及预后评估,对辅助判断淋巴瘤是否伴有骨髓浸润有重要的临床意义。Objective： This study was aimed to evaluate the significance of bone marrow （BM） morphological examination and many tumor marker（TM） detection, especially carcinoembryonic antigen （CEA）, cancer antigen 125 （CA125） , cancer antigen 15-3 （ CA15-3 ） and serum ferritin （SF） for lymphoma diagnosis and prognosis. Methods- A total of 47 confirmed patients with lymphoma in our hospital from January 2012 to October 2013 and 20 health peoplels as normal controls were performed with bone marrow morphological examination, at the same time, the electrochemistry luminescent technique was applied for detecting levels of TM （ especially CEA, CA125, CA15-3 and SF） in serum samples of lymphoma patient and normal controls, then the BM immature lymphocyte counts of these people and clinical parameters were analyzed for diagnosis and prognosis. Results： There was significant differences in all the four TM levels between serum samples of lymphoma patients and normal control （ P = 0.029, P = 0. 000, P = 0.005, P = 0.000 ）. These TM levels had no correlation with age, sex white blood cell, lymphocyte, platelet counts and anemia of lymphoma patients（P 〉 0.05 ）. It was also found that the patients with elevated TM levels had high BM immature lymphocytes （lymphoma cells）counts, B symptoms, advanced Clinical stage and high IPI index（P 〈 0.05 ）. The CA15-3 and SF levels in serum samples of lymphoma patients with BM infiltration were higher than that in lymphoma patients without BM infiltration（P = 0.002, P = 0.000）. Conclusion： Combination of BM morphological examination with serum TM level detection plays an important role in diagnosis, clinical stage and prognosis evaluation of lymphoma patients. It is also very important for assessing BM infiltration status of lymphoma patients.

关 键 词：淋巴瘤 肿瘤标志物 骨髓形态学 

分 类 号：R733.1[医药卫生—肿瘤]