發(fā)布時(shí)間：2018-01-26 09:20

  本文關(guān)鍵詞： 淋巴瘤 非霍奇金 骨髓涂片 骨髓活檢 流式細(xì)胞術(shù)　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討骨髓涂片、骨髓活檢、骨髓流式細(xì)胞術(shù)聯(lián)合應(yīng)用檢測(cè)初治非霍奇金淋巴瘤骨髓侵犯的價(jià)值,分析非霍奇金淋巴瘤骨髓侵犯的組織病理學(xué)構(gòu)成比,評(píng)估骨髓涂片、骨髓活檢及流式細(xì)胞術(shù)對(duì)非霍奇金淋巴瘤臨床分期的影響,判斷骨髓檢查對(duì)不明原因發(fā)熱病人的診斷價(jià)值。方法:收集、整理2013年3月至2016年3月在青島大學(xué)附屬醫(yī)院住院診斷的96例初治非霍奇金淋巴瘤患者的骨髓涂片、骨髓活檢及骨髓流式細(xì)胞術(shù)檢查結(jié)果,比較不同方法對(duì)非霍奇金淋巴瘤病人骨髓侵犯檢測(cè)的陽(yáng)性率,以及3種方法聯(lián)合檢測(cè)的價(jià)值。采用統(tǒng)計(jì)學(xué)軟件SPSS17.0進(jìn)行統(tǒng)計(jì)分析,計(jì)數(shù)資料采用X~2檢驗(yàn),以P0.05為差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:骨髓涂片、骨髓活檢、流式細(xì)胞術(shù)檢查及3種方法聯(lián)合應(yīng)用對(duì)非霍奇金淋巴瘤病人骨髓侵犯檢測(cè)的陽(yáng)性率分別為19.8%、22.9%、36.5%、45.8%。流式細(xì)胞術(shù)檢查對(duì)非霍奇金淋巴瘤骨髓侵犯檢測(cè)陽(yáng)性率顯著高于單用骨髓涂片和骨髓活檢(X~2=7.76,P0.05);三種方法聯(lián)合應(yīng)用對(duì)NHL骨髓侵犯檢出率最高(X~2=19.69,P0.05);骨髓涂片與骨髓活檢比較,差異無(wú)顯著性(X~2=0.28,P0.05)。骨髓涂片、骨髓活檢、流式細(xì)胞術(shù)都有助于修正非霍奇金淋巴瘤臨床分期。彌漫大B細(xì)胞淋巴瘤骨髓侵犯比例最高。對(duì)于部分不明原因發(fā)熱的病人,骨髓涂片、骨髓活檢和骨髓流式細(xì)胞術(shù)單獨(dú)或聯(lián)合檢查有助于診斷。結(jié)論:骨髓涂片、骨髓活檢及骨髓流式細(xì)胞術(shù)檢查聯(lián)合應(yīng)用有助于提高初治非霍奇金淋巴瘤骨髓侵犯檢測(cè)的陽(yáng)性率,其優(yōu)勢(shì)互補(bǔ),不可替代;3種檢查方法聯(lián)合應(yīng)用有助于修正臨床分期,對(duì)于指導(dǎo)NHL的臨床治療及評(píng)估預(yù)后有重要的價(jià)值;對(duì)于部分不明原因發(fā)熱病人進(jìn)行骨髓檢查有助于明確診斷。對(duì)于臨床上高度懷疑淋巴瘤骨髓侵犯病人,若首次骨髓活檢陰性并不能排除骨髓侵犯,換部位再次行骨髓相關(guān)檢查則有助于明確診斷。
[Abstract]:Objective: to investigate the value of bone marrow smear, bone marrow biopsy and bone marrow flow cytometry in detecting bone marrow invasion of primary non-Hodgkin 's lymphoma, and to analyze the histopathological ratio of bone marrow invasion of non-Hodgkin 's lymphoma. To evaluate the effect of bone marrow smear, bone marrow biopsy and flow cytometry on the clinical staging of non-Hodgkin 's lymphoma, and to evaluate the diagnostic value of bone marrow examination in patients with fever of unknown origin. The results of bone marrow smear, bone marrow biopsy and bone marrow flow cytometry in 96 patients with newly diagnosed non-Hodgkin 's lymphoma were collected from March 2013 to March 2016 in the affiliated Hospital of Qingdao University. The positive rate of bone marrow invasion in patients with non-Hodgkin 's lymphoma and the value of three combined methods were compared. Statistical software SPSS17.0 was used for statistical analysis. The count data were measured by X2 test, with P0.05 as the difference. Results: bone marrow smear, bone marrow biopsy. The positive rate of bone marrow invasion in patients with non-Hodgkin 's lymphoma was 19.822.9% by flow cytometry and 36.5% by combined use of three methods. The positive rate of bone marrow invasion in non-Hodgkin 's lymphoma by flow cytometry was significantly higher than that by single bone marrow smear and bone marrow biopsy. The detection rate of bone marrow invasion in NHL was the highest (P 0.05). There was no significant difference between bone marrow smear and bone marrow biopsy. Flow cytometry helps to correct the clinical staging of non-Hodgkin 's lymphoma. Diffuse large B-cell lymphoma has the highest rate of bone marrow involvement. Bone marrow smears are found in patients with partial fever of unknown origin. Bone marrow biopsy and bone marrow flow cytometry are helpful for diagnosis. Conclusion: bone marrow smears. Combined use of bone marrow biopsy and bone marrow flow cytometry is helpful to improve the positive rate of bone marrow invasion in primary non-Hodgkin 's lymphoma. The combined use of the three methods is helpful for the revision of clinical staging and is of great value in guiding the clinical treatment and evaluating the prognosis of NHL. Bone marrow examination for some patients with fever of unknown origin is helpful to the diagnosis. For patients with clinically highly suspected lymphoma bone marrow invasion, bone marrow invasion cannot be ruled out if the first bone marrow biopsy is negative. Bone marrow-related examinations at different sites will help to make a clear diagnosis.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R733.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 羅陸僑;彭雄文;;骨髓涂片和骨髓活檢對(duì)各型淋巴瘤骨髓浸潤(rùn)的診斷價(jià)值[J];診斷病理學(xué)雜志;2017年02期

2 唐寅;王蔚;高麗;孫s，

本文編號(hào)：1465254