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The background and purpose of malignant lymphoma is a highly heterogeneous tumors, particularly non-Hodgkin's lymphoma (non-Hodgkin lymphoma, NHL), the classification of its evolution is the most complex in the classification of tumors. The new WHO classification defined lymphoma morphology, immune phenotype, clinical characteristics, and genetics (in some cases) to be combined to determine the type of differentiation, immune phenotype plays an important role in the diagnosis of lymphoma. Flow cytometry (flow cytometry, FCM) is a single-cell quantitative analysis and sorting of the new technology, the use of flow cytometry analysis lymphoma immune phenotype and traditional immunohistochemical techniques, rapid, sensitive and the advantages of multi-parameter analysis. Fine needle aspiration cytology (fine-needle aspiration cytology, FNC) is a simple, fast and more accurate tumor diagnosis, but the the FNC role in the diagnosis of lymphoma has been controversial, previously available only as The initial diagnosis of lymphoma, but combined immune phenotype and genetic characteristics of detection can improve the accuracy of the diagnosis of lymphoma. The FCM and FNC combined, more mutual complementarity, to improve lymphoma diagnosis and classification of specificity and sensitivity. Foreign literature FCM / FNC in NHL diagnosis and typing with high sensitivity and specificity, and domestic with little NHL diagnosis and classification research and application of this method. Therefore, the analysis of the experimental use of FCM superficial lymph node fine needle aspiration specimens immune phenotype, combined cytologic morphology make a diagnosis, and compared with histological diagnosis of lymph node biopsy judgment FCM / FNC diagnosis and histological diagnosis The compliance rate, discussed the role and limitations of this method in the NHL diagnosis and classification. Materials and Methods superficial lymph nodes underwent fine needle aspiration cytology of Pathology, the First Affiliated Hospital of Zhengzhou University, from May 2006 to March 2007, 39 cases cytological smears prompted for the NHL and benign reactive hyperplasia (benign reactive hyperplasia, BRH) cases, the same parts of lymph node again fine needle aspiration to obtain specimens for FCM analysis. Used labeled monoclonal antibodies of CD19, κ / λ, CD5, CD10, CD23, CD3, CD2 and CD7. Combined cytologic morphology and FCM immune phenotype results to make the diagnosis and classification, and the contrast with the histological diagnosis of lymph node biopsy, the coincidence rate between the judge FCM / FNC diagnosis and histological diagnosis, to explore this approach in the NHL diagnosis and typing the role and limitations. 1.39 cases of superficial lymph node enlargement in patients with fine needle aspiration cytology smears prompted for the NHL or BRH. 39 cases diagnosed by the FCM / FNC, which NHL21 cases, BRH13 cases, suspected NHL5 cases. 21 patients with NHL, B-NHL14 cases, the T-NHL7 cases. 14 cases of B-NHL, 13 cases (92.86%) of the light chain restriction expression in 11 cases (78.57%) can accurately distinguish subtypes, including three cases of B-small lymphocytic lymphoma, three cases of follicular lymphoma and 5 patients with diffuse large B-cell lymphoma. In addition, three cases of B-NHL failed genotyping. Seven cases of T-NHL, FCM analysis of six cases of T-cell antigen expression deletion, failure to further sub-type. 2. The 39 cases of superficial lymph nodes cases after histological diagnosis, NHL 26 cases, BRH 12 histiocytic necrotizing lymphadenitis cases. 26 patients with NHL, B-NHL 16 cases and T-NHL 10 cases. 16 cases of B-NHL, B-small lymphocytic lymphoma, mantle cell lymphoma, follicular lymphoma, 4 cases, 8 cases of diffuse large B-cell lymphoma. 10 cases of T-NHL, peripheral T-cell lymphoma 6 cases of T lymphoblastic lymphoma in 2 cases, 2 cases of anaplastic large cell lymphoma. 3.39 cases of specimens FCM / the FNC diagnosis and the results of histological diagnosis coincidence rate was 84.62% (33/39), in which the NHL's diagnosis rate of 80.77% (21/26), BRH diagnosis was 100% (12/12). In the NHL, the B-NHL diagnosis coincidence rate was 87.50% (14/16), 16 cases of T-NHL diagnosis rate of 70.00% (7/10). Conclusion 1. The main immunological features of B-NHL is the expression of immunoglobulin light chain restriction. FCM / FNC a stronger specificity and sensitivity in the diagnosis of B-NHL, accurate and most B-NHL subtypes. 2. The FCM / FNC diagnostic T-NHL is more difficult than the B-NHL. FCM detected one or more T-cell antigen loss of expression is one of the most valuable indicators of the diagnosis of T-NHL. 3. The polyclonal phenotype combined cytologic features can be more definitive diagnosis of benign reactive hyperplasia, but lymph node biopsy confirmed the suspected lymphoma cases need significantly larger or clinical indications. 4. The fewer the number of tumor cells and inclusions are more reactive cell NHL FCM / FNC application of little value, such as T cell rich large B-cell lymphoma and lymphoma nodal lesions change non-diffuse cases and so on.
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