CAJ | 학술논문

目的评估流式细胞术行胸腹水免疫分型在儿童非霍奇金淋巴瘤( non-hodgkin′s lym-phoma, NHL)诊断中的应用特点. 方法 2011 年2 月—2013 年11月上海市儿童医院重症监护室( ICU)中12 例诊断NHL患儿,男11例,女1例,年龄1~13岁,对病程中首发出现胸水或腹水的患儿,均应用流式进行免疫分型分析. 免疫分型抗体包括CD45、CD10、CD33、CD7、CD1a、MPO、cCD3、CD79a、CD22、CD19、CD20、CD5、CD3、κ、λ、αβ、γδ 和 CD56 等常见的T、B和 NK标记,必要时加做CD30标记. 结果 12例伴有胸腹水的患儿最终均确诊为NHL,其病情危重,进展迅速. 流式细胞术免疫分型诊断为NHL-B系6例,其中5例为腹水,1 例为胸水,B系中CD20都出现高表达;诊断为NHL-T系4例,胸水3例,胸腹水混合1例,T系中αβ或γδ出现单克隆表达;另2例出现CD30的表达,确诊为间变大细胞淋巴瘤,2例均为胸水,其细胞形态学具有异质性. 结论胸腹水流式细胞术免疫分型在儿童淋巴瘤辅助诊断中具有早期、快速和准确的特点,为早期化疗及抢救争取了时间,并为化疗中联合应用美罗华等靶向药物提供依据.
목적 평고류식세포술행흉복수면역분형재인동비곽기금림파류( non-hodgkin′s lym-phoma, NHL)진단중적응용특점. 방법 2011 년2 월—2013 년11월상해시인동의원중증감호실( ICU)중12 례진단NHL환인,남11례,녀1례,년령1~13세,대병정중수발출현흉수혹복수적환인,균응용류식진행면역분형분석. 면역분형항체포괄CD45、CD10、CD33、CD7、CD1a、MPO、cCD3、CD79a、CD22、CD19、CD20、CD5、CD3、κ、λ、αβ、γδ 화 CD56 등상견적T、B화 NK표기,필요시가주CD30표기. 결과 12례반유흉복수적환인최종균학진위NHL,기병정위중,진전신속. 류식세포술면역분형진단위NHL-B계6례,기중5례위복수,1 례위흉수,B계중CD20도출현고표체;진단위NHL-T계4례,흉수3례,흉복수혼합1례,T계중αβ혹γδ출현단극륭표체;령2례출현CD30적표체,학진위간변대세포림파류,2례균위흉수,기세포형태학구유이질성. 결론 흉복수류식세포술면역분형재인동림파류보조진단중구유조기、쾌속화준학적특점,위조기화료급창구쟁취료시간,병위화료중연합응용미라화등파향약물제공의거.
Objective To evaluate the practicability of using flow cytometry analysis for diagnosis of non-hodgkin′s lymphoma ( NHL) among children with serous effusion.Methods Twelve children who were diagnosed with malignant lymphoma from February 2011 to November 2013 at Shanghai Children′s hos-pital were recruited in this study.Pleural effusion and ascites samples were collected from those children who showed serous effusion as initial symptoms and analyzed by using flow cytometry based immunophenotyping. The antibodies used for immunophenotyping included CD45, CD10, CD33, CD7, CD1a, MPO, cCD3, CD79a, CD22, CD19, CD20, CD5, CD3,κ,λ,αβ,γδ,CD56 and other common markers for T, B and NK cells.Anti-CD30 antibody was used when necessary.Results All of the twelve cases with serous effusion were diagnosed with aggressive NHL.Six out of the twelve children including five cases with ascites and one case with pleural effusion showed high expression of CD20 and were classified as NHL-B type by flow cytom-etry.Three children with pleural effusion and one child with both pleural effusion and ascites were typed as NHL-T as characterized by monoclonal expression of αβorγδ.The other two children with pleural effusion were diagnosed with anaplastic large cell lymphoma with positive expression of CD30 and morphological het-erogeneity.Conclusion Flow cytometry analysis based immunophenotyping could be used as an auxiliary method for rapid and accurate diagnosis of lymphoma in children with serous effusions.