流式细胞术检测外周血淋巴细胞诊断淋巴瘤的应用研究

目的:探讨流式细胞术(FCM)检测外周血淋巴细胞在淋巴瘤诊断中的应用价值。方法:通过筛选2011年8月至2017年8月期间初诊的皮肤淋巴瘤病例25例,淋巴节良性病变6例,采用FCM检测外周血淋巴细胞表面抗原分子,通过与病理切片HE染色和免疫组化法(金标准)比较,分析两种检测方法之间的差异。结果:在31例检测病例中,FCM检测结果与金标准检测结果一致性较高(Kappa=0.61):26例检查结果相同,5例检查结果不一致;检测19例T淋巴细胞淋巴瘤,FCM检测结果与金标准检测结果一致性也较高(Kappa=0.57):检测14例初诊为T细胞淋巴瘤病例,FCM检测T淋巴瘤细胞的表面抗原标志CD3分子为阳性,与组织学结果相符,另有5例T细胞淋巴瘤病例HE染色和免疫组化诊断明确,而FCM未能检出。检测6例B细胞淋巴瘤病例,6例淋巴瘤病例FCM检测结果都为阳性,FCM检测B淋巴瘤细胞的表面抗原标志CD19分子为阳性,与金标准检测结果符合率为100%。6例淋巴节良性病变病例FCM检测结果与金标准检测结果一致。结论:通过FCM检测外周血可以检测出部分皮肤淋巴瘤,FCM在皮肤淋巴瘤诊断和分型中有一定的临床价值,是检测皮肤淋巴瘤的有效的辅助方法。

The Application of Flow Cytometry (FCM) for Detecting Peripheral Blood Immunophenotype in Diagnosis of Lymphoma

ABSTRACT Objective: To analyze clinical value of flow cytometry (FCM) for detecting peripheral blood immunophenotype in diagnosis of cutaneous lymphoma. Methods: Peripheral blood and biopsy specimens from 25 persons who were suspected as cutaneous lymphoma and 6 persons with benign lesions of lymph node were collected. The comparison between FCM and HE staining & immunohistochemistry (IHC, gold standard) in diagnosis of lymphoma was made. Results: In all 31 cases, the FCM test results are in good agreement with the gold standard test results (Kappa=0.61): the results of the examination were the same in 26 cases, and the results of 5 cases were inconsistent. In the 19 TNHL(T cell non-Hodgkin lymphoma, TNHL) cases, the FCM test results are also in good agreement with the gold standard test results(Kappa=0.57). In the 19 cases of T cell lymphoma, the 14 cases of newly diagnosed T cell lymphoma were detected by FCM. Abnormal peripheral blood lymphocyte subsets could be detected by FCM. The surface antigen marker of T lymphoma cells from peripheral blood was positive for CD3 by FCM, which was consistent with histological findings. FCM and HE staining & IHC were equally effective for diagnosis of lymphoma in 14 patients. But FCM did not detected abnormal cells in 5 patient with T lymphoma. Abnormal peripheral blood lymphocyte subsets could be detected by FCM in the 6 cases of B cell lymphoma. The surface antigen marker of B lymphoma cells from peripheral blood was positive for CD19 by FCM, which was consistent with histological findings. In 6 cases with benign lesions of lymph node, the FCM test results are also in good agreement with the gold standard test results. Conclusion: The immunophenotye analysis by FCM was used to diagnose cutaneous lymphoma and provided an approach to increase sensitivity for diagnosis of lymphoma.