骨髓细胞形态学、免疫组化、PCR诊断淋巴瘤骨髓侵犯的价值  

Value of Bone Marrow Cell Morphology,Immunohistochemistry and PCR in Diagnosing Lymphoma with Bone Marrow Involvement

作　　者：廖伟莲 LIAO Weilian(Department of Pathology,Ganzhou Cancer Hospital,Ganzhou 341000,China)

机构地区：[1]赣州市肿瘤医院病理科,江西赣州341000

出　　处：《中国医学创新》2024年第24期155-158,共4页Medical Innovation of China

摘　　要：目的:探讨骨髓细胞形态学、免疫组化、聚合酶链反应(PCR)诊断淋巴瘤骨髓侵犯的价值。方法:选取赣州市肿瘤医院2021年1月—2023年8月收治的81例淋巴瘤患者,均接受骨髓细胞形态学、骨髓涂片免疫组化、PCR检测,分析三者单独及联合检出骨髓侵犯的价值。结果:81例患者中,骨髓活检检出21例、骨髓细胞形态学检出32例、骨髓涂片免疫组化检出36例,PCR检出19例。其中,联合检测与骨髓活检的一致性最好,Kappa值为0.875;以骨髓活检为参考标准,骨髓细胞形态学、骨髓涂片免疫组化、PCR及联合检测的敏感度分别为80.95%、90.48%、71.43%、95.24%,特异度分别为75.00%、71.67%、93.33%、95.00%,准确率分别为76.54%、76.54%、87.65%、95.06%,阳性预测值分别为53.13%,52.78%、78.95%、86.96%,阴性预测值分别为91.84%、95.56%、90.32%、98.28%。联合检测的敏感度高于PCR单项检测,特异度、准确率、阳性预测值均高于骨髓细胞形态学、骨髓涂片免疫组化单项检测(P<0.05)。结论:淋巴瘤患者骨髓细胞形态学检查联合骨髓涂片免疫组化、PCR检查可明显提高对骨髓侵犯的诊断效能。Objective:To explore the value of bone marrow cell morphology,immunohistochemistry and polymerase chain reaction(PCR)in the diagnosis of lymphoma with bone marrow involvement.Method:A total of 81 patients with lymphoma in Ganzhou Cancer Hospital were selected from January 2021 to August 2023.All patients underwent bone marrow cell morphology,bone marrow smear immunohistochemistry and PCR detection,and the value of the three alone and combined detection on bone marrow involvement were analyzed.Result:Among 81 patients,21 cases were detected by bone marrow biopsy,32 cases were detected by bone marrow cell morphology,36 cases were detected by bone marrow smear immunohistochemistry and 19 cases were detected by PCR.The consistency between combined detection and bone marrow biopsy was the best,with Kappa value of 0.875.Taking bone marrow biopsy as the reference standard,the sensitivities of bone marrow cell morphology detection,bone marrow smear immunohistochemistry,PCR and combined detection were 80.95%,90.48%,71.43%and 95.24%,the specificities were 75.00%,71.67%,93.33%and 95.00%,accuracy rates were 76.54%,76.54%,87.65%and 95.06%,the positive predictive values were 53.13%,52.78%,78.95%and 86.96%,and the negative predictive values were 91.84%,95.56%,90.32%and 98.28%respectively.The sensitivity of combined detection was higher than that of PCR single detection,and the specificity,accuracy rate and positive predictive value were higher than those of bone marrow cell morphology and bone marrow smear immunohistochemistry(P<0.05).Conclusion:Bone marrow cell morphology examination combined with bone marrow smear immunohistochemistry and PCR can significantly improve the diagnostic efficiency on bone marrow involvement in patients with lymphoma.

关 键 词：淋巴瘤 骨髓侵犯 骨髓细胞形态学 免疫组化 聚合酶链反应 

分 类 号：R733.1[医药卫生—肿瘤]