脾脏细针穿刺针吸细胞学联合流式细胞术对淋巴瘤诊断价值分析  

Clinical application of fine needle aspiration cytology combined with flow cytometry in diagnosis and classification of spleen lymphoma

作　　者：刘平毅[1] 陈玲玲[1] 

机构地区：[1]临沂市沂水中心医院检验科,山东临沂276400

出　　处：《中华肿瘤防治杂志》2015年第21期1688-1694,共7页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的脾脏细针穿刺针吸细胞学(fine-needle aspiration cytology,FNAC)和流式细胞术(flow cytometry,FCM)均有优势与不足,本研究探讨FNAC联合FCM在诊断脾脏淋巴瘤中的应用价值。方法选取2013-01-01-2014-12-31临沂市沂水中心医院收治的16例脾脏肿大高度怀疑淋巴瘤浸润患者为研究对象。均行FNAC检查,同时运用FCM分析针吸标本中各细胞的免疫表型,并将FNAC联合FCM的检测结果与病理组织学结果进行比较。结果 16例穿刺标本,经FNAC检出淋巴瘤10例,其中霍奇金淋巴瘤(hodgkin lymphoma,HL)2例,非霍奇金淋巴瘤(non-hodgkin lyrnphoma,NHL)8例;脾脏功能亢进2例;脾脏髓外造血1例;反应性增生(benign reactive hyperplasia,BRH)3例。16例标本,经FCM检出淋巴瘤9例,其中B-小淋巴细胞淋巴瘤(B-small lymphocytic lymphoma,B-SLL)6例,弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)2例,1例为T-NHL;2例为BRH;另外5例经FCM分析其淋巴细胞群未见异常。FNAC联合FCM检出淋巴瘤11例,脾脏功能亢进2例,脾脏髓外造血1例,脾脏淋巴组织增生2例;其中1例经FNAC及FCM检测结果为淋巴组织增生,而其病理结果为脾脏转移癌,其余结果均与病理结果相符。FNAC联合FCM检测结果的准确率为93.75%(15/16),淋巴瘤的诊断符合率为100%。结论脾脏FNAC与FCM的联合运用不仅可观察病变细胞的形态,而且可以同时对同一细胞的多个免疫标记进行分析,提高了脾脏淋巴瘤诊断的准确率,是脾脏淋巴瘤诊断的一种方便快捷、安全有效且高度精确的试验方法。OBJECTIVE To evaluate the value of fine needle aspiration biopsy （FNAB） combined with flow cytometry （FCM） in the diagnosis of spleen lymphoma. METHODS Fine-needle aspiration cytology （FNAC） was performed on 16 patients with enlarged spleens from January of 2013 to December of 2014 in our hospital, these patients were highly suspected for lymphoma infiltration in spleen. We analyzed the immune phenotype of biopsy specimens by flow cytometry and the results were compared with histopathology results. RESULTS There were 10 patients with lymphoma infiltrating in the 16 patients by the examination of fine-needle aspiration cytology. Two cases were diagnosed with Hodgkin Lympboma,eight cases with Non-Hodgkin Lyrnphoma, two cases with the spleen function, one case with Spleen marrow hemato poietic, and three cases with benign reactive hyperplasia. We found nine cases with lymphoma by flow cytometry in 16 pa tients, six cases were diagnosed with B- small lymphocytic lymphoma,two cases with Diffuse large B cell lymphoma and one case with T cell lymphoma. Two cases were diagnosed with benign reactive hyperplasia. We didn＇t find abnormalities throw analysis the lymphocyte group by flow cytometry in the other 5 patients. With combined FANC/FCM, eleven cases were diagnosed as lymphoma, two cases as hypersplenism, one case as extramedullary hematopoiesis in splen, and two cases as hyperplasia of lymphoid tissue of spleen. The accuracy of FNAC combined with FCM was 93.75 % （15/16）, the diagnosis rate of lymphoma was 100% . CONCLUSIONS Our results show that a combination of FANC/FCM is a con- venient, safe, effective and highly accurate method in the diagnosis of splenic lymphoma. We can not only observe the form of diseased cells, but also analyze the multiple immune markers of the same cell by this method. It improves the accuracy of the diagnosis of splenic lymphoma, reduce the patient＇s pain and it＇s a great significance for subtyping and treatmen of splenic lymphoma.

关 键 词：淋巴瘤 脾脏 细针穿刺细胞学 流式细胞术 免疫表型 

分 类 号：R733.1[医药卫生—肿瘤] R730.43[医药卫生—临床医学]