周月平

[摘要]目的 探讨骨髓形态联合免疫分型检测在慢性淋巴细胞白血病中的应用。方法 选取我院2015年5月～2018年12月收治的80例慢性淋巴细胞白血病患者的临床资料，均采用流式细胞术对骨髓或者外周血标本进行免疫表型检测。依据细胞形态学差异分为典型组（65例）和混合组（15例）。分析骨髓形态学特征和免疫分型情况，比较两组抗原表达阳性率。结果 骨髓形态学特征方面，所有患者淋巴细胞比例明显增高，伴有不同比例的幼稚淋巴细胞、粒系、红系及巨核系表现不同程度减少。80例患者中，抗原表达阳性率由高到低依次为CD19、HLA-DR、CD5、CD20、CD22、CD23、CD38、FMC-7。两组CD5、CD19、CD20、CD22、CD23、FMC-7和HLA-DR阳性表达率比较，差异无统计学意义（P>0.05），但混合组CD38的阳性表达率高于典型组，差异有统计学意义（P<0.05）。结论 慢性淋巴细胞白血病的临床检查中，骨髓形态联合免疫分型检测具有一定的诊断和鉴别效果，但仍需进一步探究证实。

[关键词]白血病;淋巴细胞;免疫分型;骨髓形态

[中图分类号] R44          [文献标识码] A          [文章编号] 1674-4721（2020）8（c）-0158-03

[Abstract] Objective To explore the application of bone marrow morphology combined with immunotyping in chronic lymphocytic leukemia. Methods From May 2015 to December 2018， 80 patients with chronic lymphocytic leukemia admitted to our hospital were tested for immunophenotypes in bone marrow or peripheral blood samples by flow cytometry. Immunophenotype detection was performed on bone marrow or peripheral blood samples by flow cytometry. According to the cell morphology， they were divided into typical group （65 cases） and mixed group（15 cases）. The morphological characteristics and immunotyping of bone marrow were analyzed， and the positive rates of antigen expression in the two groups were compared. Results In terms of the morphological characteristics of bone marrow， the proportion of lymphocytes increased significantly in all patients， accompanied by different proportions of juvenile lymphocytes， granulocytes， red lines and megakaryons showed different degrees of decrease. Among the 80 patients， the positive rates of antigen expression were CD19， HLA-DR， CD5， CD20， CD22， CD23， CD38 and FMC-7 in descending order. There were no statistically significant differences in the positive expression rates of CD5， CD19， CD20， CD22， CD23，FMC-7and HLA-DR between the two groups （P>0.05）， but the positive expression rate of CD38 in the mixed group was higher than that in the typical group， the difference was statistically significant （P<0.05）. Conclusion In the clinical examination of chronic lymphocytic leukemia， bone marrow morphology combined with immunotyping has certain diagnostic and differential effects， but it still needs to be further confirmed.

[Key words] Leukemia; Lymphocyte; Immunotyping; Bone marrow morphology

白血病是临床致死率最高的疾病之一，是世界各国卫生组织高度关注的疾病类型。慢性淋巴細胞白血病是淋巴细胞的恶性增殖性疾病，在临床上并不少见，具有一定的发病率，其主要特点为看似成熟的小淋巴细胞聚集在了外周血液、骨髓、外周淋巴器官[1]。近年来，慢性淋巴细胞白血病的发病率逐年上升，严重威胁到人类的身体健康和生命安全。因此，加强对该病的检测研究，对临床诊治和预后的改善有十分积极的意义[2]。骨髓形态检测和免疫分型检测在淋巴细胞恶性增生性疾病的检测中已被广泛使用，取得了良好的检测效果。但是……