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目的评价流式细胞术联合细胞遗传学检查在恶性淋巴瘤确诊中意义。方法笔者医院2009~2012年29例门诊及住院疑似淋巴瘤患者淋巴组织标本,制备单个核悬浮细胞,分别行流式细胞术检测细胞表面抗原的表达和R-显带检测细胞遗传学细胞核型。结果 29例患者中8例病理诊断为反应性增生或慢性炎,通过流式细胞仪和细胞遗传学诊断恶性淋巴瘤,12例患者发现核型异常,流式细胞术细胞表面抗原的检测可区分B淋系还是T淋系,区分不同亚型有指导意义,12例患者检测到异常核型,其中4例淋巴结病理提示淋巴结炎或者增生但核型发现异常染色体改变,肯定了为恶性改变,并发现有与亚型相关的特异性核型改变t(11;14),t(14;18),9例患者为复杂核型,提示预后不良。结论淋巴组织病理学检查是诊断恶性淋巴瘤的基础,结合流式细胞术以及染色体检查可以提高恶性淋巴瘤的诊断率,并对淋巴瘤亚型分型以及预后判断具有指导性意义。
Objective To evaluate the significance of flow cytometry combined with cytogenetics in the diagnosis of malignant lymphoma. Methods The author from 2009 to 2012, 29 cases of outpatients and hospitalized patients with suspected lymphoma lymphoid tissue specimens, preparation of single nuclear suspension cells were detected by flow cytometry of cell surface antigen expression and R-banding detection of cytogenetic cytoplasmic karyotype. Results Of the 29 patients, 8 were pathologically diagnosed as reactive hyperplasia or chronic inflammation. Malignant lymphoma was diagnosed by flow cytometry and cytogenetics, and karyotypic abnormalities were found in 12 patients. The detection of cell surface antigens by flow cytometry was distinguishable B lymph node or T lymph node, distinguish between different subtypes has guiding significance, 12 patients detected abnormal karyotype, including 4 cases of lymph node pathology prompted lymphadenitis or hyperplasia but karyotype found abnormal chromosome change, affirmed the malignant change, and A specific karyotype associated with the subtype was found to be altered t (11; 14), t (14; 18). Nine patients had complex karyotypes, suggesting a poor prognosis. Conclusion Lymphatic histopathology is the basis of diagnosis of malignant lymphoma. Combined with flow cytometry and chromosome examination, it can improve the diagnosis rate of malignant lymphoma and has instructive significance in the subtyping and prognosis of lymphoma.