流式细胞术和病理骨髓活检在非霍奇金淋巴瘤骨髓侵犯的诊断价值比较

目的分析并比较流式细胞术免疫分型和病理骨髓活组织检查非霍奇金淋巴瘤（NHL）骨髓侵犯的诊断价值。方法初诊淋巴瘤的标本253例分别作流式细胞术免疫分型和病理骨髓活检，以临床综合诊断为金标准，分析2种方法的敏感度和特异度等检验效能，并对不同亚型NHL进行分类，分析不同检测方法的骨髓侵犯发生率。结果流式细胞术检测骨髓侵犯发生率的灵敏度为91.67%（88/96），高于病理骨髓活检的82.29%（79/96），但差异无统计学意义（χ2=0.16，P>0.05），2种方法的特异度均为100.00%（157/157）。套细胞淋巴瘤的骨髓侵犯发生率较高，分别为84.00%（金标准）、80.00%（流式细胞术）和68.00%（病理骨髓活检），弥漫大B细胞淋巴瘤的骨髓侵犯发生率较低，分别为23.75%（金标准）、22.50%（流式细胞术）和22.50%（病理骨髓活检）；慢性淋巴细胞白血病/小细胞淋巴瘤的病理骨髓活检与金标准相比，差异有统计学意义（P < 0.01）；套细胞淋巴瘤、慢性淋巴细胞白血病/小细胞淋巴瘤、滤泡细胞淋巴瘤、B-NHL未分类的骨髓侵犯率，流式细胞术较病理骨髓活检为高，而T/NK细胞淋巴瘤，流式细胞术检出的骨髓侵犯率偏低。结论流式细胞术对于NHL的检验效能较高，是一种灵敏、高效的检测方法。

Comparison of the diagnostic value between flow cytometry and pathological bone marrow biopsy in bone marrow invasion of non-Hodgkin's lymphoma

ObjectiveTo compare the diagnostic value between flow cytometry immunotyping and pathological bone marrow biopsy in bone marrow invasion of non-Hodgkin's lymphoma(NHL).MethodsFlow cytometry immunotyping and pathological bone marrow biopsy were performed in 253 cases of lymphoma.Using clinical comprehensive diagnosis as the gold standard, the sensitivity and specificity of two methods were analyzed, the different subtypes of NHL were classified, and the incidence rate of bone marrow invasion was analyzed using different detection methods.ResultsThe sensitivity of the flow cytometry in detecting the incidence rate of bone marrow invasion was 91.67%(88/96), which was higher than that of pathological bone marrow biopsy 82.29%(79/96), and the difference of which was not statistically significant(χ2=0.16, P>0.05).The specificity of both methods were 100.00%.The incidence rates of bone marrow invasion of mantle cell lymphoma using gold standard, flow cytometry and pathological bone marrow biopsy were 84.00%, 80.00% and 68.00%, respectively.The incidence rates of bone marrow invasion of diffuse large B-cell lymphoma using gold standard, flow cytometry and pathological bone marrow biopsy were 23.75%, 22.50% and 22.50%, respectively.The differences of the detection between gold standard and pathological bone marrow biopsy in chronic lymphocytic leukemia/small cell lymphoma were statistically significant(P < 0.01).The incidence rates of bone marrow invasion in mantle cell lymphoma, chronic lymphocytic leukemia/small cell lymphoma, follicular cell lymphoma, B-NHL unclassified detected by flow cytometry were higher than that of pathological bone marrow biopsy, while for T/NK cell lymphoma, the bone marrow invasion rate detected by flow cytometry was lower.ConclusionsFlow cytometry is a sensitive and efficient method in the detection of NHL.