调节性T细胞在血液系统恶性肿瘤中的研究进展

胸腺产生的CD^＋4CD^＋25调节性T细胞（Treg细胞）被认为在控制自身免疫、防止移植物排斥反应、抑制抗感染自身免疫以及抑制异基因免疫反应中发挥重要作用。最近有报道此类细胞有抑制机体抗肿瘤的作用。Foxp3是Treg细胞最具特异性的蛋白分子标志物。阐述了血液系统恶性肿瘤患者CD^＋4CD^＋25去Foxp3 Treg的表达以及其对免疫治疗的潜在作用。     

全身骨髓显像在恶性肿瘤诊治中的应用

我们在临床工作中发现全身骨髓显像能更早期地发现恶性肿瘤骨转移灶,对病人的临床分期、治疗方案的制订、疗效评价及预后判断均有重要价值。现将我院1998年9月—1999年9月所作的30例患者骨髓显像及骨显像结果分析报告如下。收稿日期:1999-11-03;修回日期:2000-02-28基金项目:该课题系攀钢(集团)公司1999年度科研项目(99科医113)作者单位:攀钢总医院,四川　攀枝花　6170231　材料与方法1.1　检查对象　本组病例,均经临床、病理学确诊为恶性肿瘤,根据恶性肿瘤诊治规范进行分期。30例中,男性15例,女性15例,年龄4.5岁～72岁,中位年龄42.3岁。病…     

看看你血液里都有些啥?——骨髓(血液之源)

血液滋养着我们身体的每一个角落,没有血液浇灌人就不能存活,然而,血液也可以把病原体散布全身而置人于危险境地. 你了解自己的血液、骨髓吗?它们从何而来,又有什么作用?我们生病了在医院常常会去"验个血",也就是血常规检查,红细胞、白细胞、血小板等等,它们的家就是骨髓,那里是血之源.     

血液肿瘤致骨髓坏死26例分析

骨髓坏死(bone marrow necrosis)是指因多种疾病所致的骨髓内造血细胞发生原位死亡,临床较少见.其常见病因有血液性疾病、转移性骨肿瘤、恶性淋巴瘤、严重感染等.现将我院收治的26例骨髓坏死报道如下.     

癌细胞激活血液免疫反应路线图实验体系

癌细胞是抗原性细胞,能激活血液免疫反应,可用于构建血液免疫反应路线图实验体系,可观察多种免疫检测指标变化(包括血细胞粘附率,IL-8、IL-12、CD35、CD44、CD55、CD58、CD4、CD8、CD2、CXCR4、Fy6等).癌细胞(S180)激活免疫反应能创立有效的多种免疫学研究方法,用于研究血液免疫反应中血细胞与血浆,红细胞与白细胞之间的内在联系.为天然免疫与获得性免疫研究,为血液免疫反应路线图理论研究,为在临床上对肿瘤进行免疫治疗提供有效的研究方法.     

树突状细胞及其在血液系统肿瘤免疫治疗中的应用

树突状细胞(DC)是体内功能最强的抗原提呈细胞,由DC激活的T细胞免疫在抗肿瘤过程中起着主导作用。关于DC肿瘤疫苗在血液系统肿瘤免疫治疗方面应用的结果已显示出DC疫苗在血液系统肿瘤治疗中有巨大的应用前景。就国内外有关DC的生物学特征和DC疫苗在血液系统肿瘤免疫治疗中的研究进展作一综述。     

骨髓活检在血液肿瘤疾病中的诊断价值

在诊断肿瘤性疾病时，病理学诊断是必不可少的“金标准”，但是骨髓活检并不等同于血液病理学检查，需结合骨髓涂片以及其他生化和免疫学等方法。尤其是近20年来，随着细胞与分子生物学技术被应用于诊断之中，对于骨髓活检在血液学肿瘤诊断中的价值更需综合考虑。尽管如此，骨髓活检在诊断血液系统疾病、动态观察疾病进展变化以及判断预后等方面，还是具有其他实验室检查所无法取代的价值。     

ECT骨显像和骨髓涂片在神经母细胞瘤骨转移中的临床应用

目的:探讨ECT骨显像和骨髓涂片在神经母细胞瘤骨转移的临床应用价值。方法:回顾性分析2011年10月至2018年10月我院收治的216例经病理组织、淋巴结或骨髓活检确诊为神经母细胞瘤患者的临床资料,收集同一时段内的ECT骨显像和骨髓涂片结果,分析两种方法在神经母细胞瘤骨转移的临床应用价值。结果:ECT骨显像阳性106例,ECT骨显像阴性110例,阳性率49.07%;骨髓涂片阳性84例,骨髓涂片阴性132例,阳性率38.89%。ECT骨显像阳性而骨髓涂片阴性组46例,占21.30%;ECT骨显像阴性而骨髓涂片阳性组24例,占11.11%;ECT骨显像及骨髓涂片均阳性组60例,ECT骨显像及骨髓涂片均阴性组86例,两种方法在诊断神经母细胞瘤患者有无骨转移的符合率为67.59%。在106例ECT骨显像阳性中骨髓涂片阳性有60例,骨髓转移阳性率为56.60%,说明ECT骨显像提示骨转移时已有56.60%患者发生骨髓转移。结论:ECT骨显像和骨髓涂片检查在神经母细胞瘤患者骨转移的临床分期、疗效和预后评估具有重要的临床意义,建议临床应同时行ECT骨显像和骨髓涂片检查,以提高神经母细胞瘤骨转移的检出率及准确率。     

TRAIL及其在血液系统恶性肿瘤中的治疗进展

细胞凋亡（apoptosis）与肿瘤的发生、发展和转移有密切关系,诱导肿瘤细胞凋亡以达到治疗目的是近几年肿瘤治疗的热点之一。肿瘤坏死因子相关的凋亡诱导配体（TNF-related apoptosis-inducing ligand,TRAIL）是新近发现的TNF超家族成员,它能选择性的诱导肿瘤细胞和转化细胞发生凋亡,且与血液系统肿瘤常用的化疗药物具有协同性,还能克服一部分多药耐药现象,而对正常细胞没有显毒性效应,这些特性使TRAIL在血液系统恶性肿瘤的治疗中具有很大的应用前景。本就其结构、功能、作用机制及抗血液病肿瘤研究最新进展作一综述。     

Bone marrow regeneration following fractionated radiation therapy

Eighty patients were studied with ^99mTc-S colloid bone marrow scans prior to or at various intervals following megavoltage irradiation. None had marrow tumor involvement and none had chemotherapy during the study period. If reticuloendothelial marrow activity reflects hematopoietic activity, there appears to be maximal depression of marrow activity 6 months post irradiation. There appears to be evidence of marrow regeneration in the 9 month to 1 ear interval post irradiation in about half of the patients that had received a median dose of 4000 rad in 4 weeks. There was a trend toward increasing activity several years post irradiation. Total nodal irradiated patients regenerated marrow as well as “local field” patients despite the larger marrow volume irradiated. Peripheral extension of marrow accompanied regeneration in the majority of patients (57 %), and was uncommon with marrow ablation (14 % ).     

Bone marrow hyaluronan distribution in patients with acute myeloid leukemia

Acute myeloid leukemia (AML) is a clonal disorder characterized by abnormal proliferation of myeloid cell precursors. Research has mainly focused on the cellular events, but the bone marrow matrix has attracted minor interest. In this study bone marrow biopsies were obtained from 35 newly diagnosed AML patients. The bone marrows were analyzed regarding the occurrence and distribution of hyaluronan (HYA) and reticulin fibers (type III collagen). The bone marrow sections were analyzed histochemically and compared with bone marrows from 30 healthy controls. The HYA staining was significantly stronger in the AML patients compared with the controls. Only one patient demonstrated abnormal reticulin staining score, but in the group of patients with antecedent myelodysplastic syndrome (MDS), the reticulin staining score was significantly higher compared with the patients with de novo AML. There was a significant correlation between the HYA staining and reticulin staining scores in the AML patients as was seen in the control group.     

Bone marrow transplantation for severe aplastic anemia secondary to temozolomide

Radiotherapy (RT) and concomitant/adjuvant therapy with temozolomide (Temodar) is a common treatment regimen for children and adults with glioma. Although temozolomide is generally well tolerated with temporary myelosuppression as the primary dose-limiting toxicity, irreversible bone-marrow aplasia after treatment with temozolomide has been reported. We report the case of an adolescent patient with a high-grade glioma who, after >2 years of event-free survival, underwent successful bone marrow transplantation for treatment of temozolomide-induced severe aplastic anemia (SAA).     

白血病骨髓磁共振成像的定量测定

背景与目的:国内外对白血病骨髓磁共振成像(MRI)及MRI与临床实验室指标的相关性进行了大量的研究,但将淋巴细胞性白血病(lymphoidleukemia,LL)与髓细胞白血病(myeloidleukemia,ML)分开研究的不多。本研究分别测量LL与ML脊柱骨髓MRI信号强度比(signalintensityratio,SIR),探讨MRI定量测量在白血病组织学定性诊断(LL与ML)及肿瘤负荷评价中的作用。方法:对初诊的20例LL,10例ML进行脊柱骨髓MRI检查,全部白血病的诊断均经骨髓细胞学检查证实。脊柱骨髓MRI检查使用0.5T超导型磁共振成像系统,进行自旋回波(spinecho,SE)序列T1加权像(T1WI)及快速自旋回波(turbospinecho,TSE)序列T2加权像(T2WI),在T1WI上测量白血病骨髓SIR,同时进行外周血常规检查及髂骨骨髓细胞学检查。结果:20例LL和10例ML脊柱骨髓SIR分别为0.72±0.11、0.73±0.11,LL与ML之间SIR无统计学差异(P=0.836)。LL中脊柱骨髓SIR与骨髓内淋巴系幼稚细胞比均呈负相关(r=-0.836,P=0.000)。ML脊柱骨髓SIR与骨髓内粒系幼稚细胞比呈负相关(r=-0.673,P=0.033)。结论:SIR不能区分LL、ML,其组织学定性诊断价值有限,但SIR可评价白血病的肿瘤负荷。     

淋巴瘤侵犯骨髓的骨髓活检病理学诊断研究进展

淋巴瘤侵犯骨髓(lymphomabonemarrowinvolvement,LBMI)主要靠骨髓活检确诊。霍奇金淋巴瘤(Hodgkin蒺slymphoma,HL)、非霍奇金淋巴瘤(non-Hodgkin蒺slymphoma,NHL)侵犯骨髓各有其不同病理特点。骨髓中瘤细胞的形态特点、分布方式及免疫表型多数与髓外部位一致,少数又可存在差别。本文比较了各型HL、B-NHL、T-NHL的骨髓侵犯病理学特点,并从形态学、免疫组化及淋巴瘤基因重排检测三方面对LBMI的骨髓活检诊断研究进展进行了综述。     

骨髓活检对诊断非霍奇金淋巴瘤骨髓浸润及分期意义的探讨

目的:探讨骨髓活检切片分析在非霍奇金淋巴瘤骨髓浸润(NHLBMI)诊断及临床分期方面的价值。方法:对128例非霍奇金淋巴瘤患者行骨髓活检术,分析活检切片。结果:骨髓活检切片中非霍奇金淋巴瘤骨髓浸润的阳性率为35.9%(46例)。经骨髓活检后,16例Ⅰ～Ⅲ期提升为Ⅳ期,骨髓活检前、后Ⅳ期所占比例有明显差异(P<0.01)。结论:骨髓活检切片分析对非霍奇金淋巴瘤骨髓浸润的诊断及临床分期具有重要意义。     

伴PET/CT骨髓弥漫性糖代谢增高的淋巴瘤患者骨髓浸润情况及相关因素分析

背景与目的：正电子发射计算机断层显像技术(positron emission tomography-computed tomography,PET/CT)在淋巴瘤的诊断、治疗和随访中发挥着越来越重要的作用。该研究旨在探索PET/CT显示骨髓弥漫性糖代谢异常增高的淋巴瘤患者骨髓有无浸润、淋巴瘤病理类型以及其他临床特点。方法：回顾性分析复旦大学附属中山医院62例经病理确诊为淋巴瘤且PET/CT显示骨髓弥漫性糖代谢增高患者的临床资料、病理以及PET/CT详细数据,并行统计学分析。结果：PET/CT显示有骨髓弥漫性糖代谢异常增高的患者,其淋巴瘤病理类型分布与国内所报道各亚型淋巴瘤发病比例基本一致;侵袭性与惰性淋巴瘤之间［标准摄取值(standard uptake value,SUV)分别为8.43与5.38,P=0.048］、有或无B症状之间(SUV分别为8.30与5.72,P=0.033)、有或无骨髓浸润之间(SUV分别为8.78与6.96,P=0.020),SUV的差异均有统计学意义。32例(51.6%)患者经骨髓活检病理证实骨髓受累。骨髓受累者其淋巴瘤病理类型的分布上与未受累者差异有统计学意义(P=0.001);骨髓受累者套细胞淋巴瘤、结内边缘区B细胞淋巴瘤、伯基特淋巴瘤和间变大细胞淋巴瘤者比例较高,而骨髓未受累者弥漫大B细胞淋巴瘤、外周T细胞淋巴瘤、肠病相关性T细胞淋巴瘤和NK/T细胞淋巴瘤(鼻型)者比例较高。PET/CT骨摄取假阳性可能与发热、贫血等有关。结论：PET/CT骨髓弥漫性糖代谢异常增高虽然对临床诊疗有一定的提示,但应结合PET/CT骨糖代谢异常增高的特点、患者的临床因素及病理亚型综合分析,以减少误诊与漏诊,更精确地指导分期及治疗。     

Thermal marrow expansion: effect of temperature on bone marrow distribution

The distribution of bone marrow in adult mammals is limited mainly to those bones deeply embedded in the body and subject to the higher core body temperature. Active marrow is much less prevalent in the limbs. In the past this was attributed to the lower temperature of the peripheral bone marrow. We have studied the possibility of stimulating hematopoiesis in the limbs (and tails) by increasing the limb temperature. This has been done by elevating the ambient temperature of mice and by tail implantation techniques. Mice incubated at ambient temperature of 22 degrees C can be "expanded" to have markedly enhanced marrow activity in the limbs by either incubation for seven days or more at 34 degrees C, or by implantation of the bone into core temperature areas (peritoneal implantation). The increase in marrow activity is shown both histologically and by 59Fe uptake techniques. Anemia does not enhance this effect, indicating a local phenomenon. A variety of experiments suggest that temperature per se and not temperature-induced increase in blood flow is involved. The increase in marrow activity is accompanied by a modest local increase in clonogenic marrow stem cells but it cannot be shown for certainty whether the phenomenon of Thermal Marrow Expansion (TME) is due to the local effect of elevated temperature on stem or stromal cells. The erythrocytes produced by TME appear normal by in vivo fragility testing. TME may have clinical usefulness in man if the phenomenon occurs in the same fashion as rodents.     

100例骨髓转移癌骨髓组织病理学的观察

目的：观察100例骨髓转移癌患者骨髓组织病理学的改变,并与骨髓涂片结果进行比较。方法：100例骨髓转移癌患者骨髓检查,行一步法骨髓抽吸取材,石蜡或塑料包埋骨髓组织,切片2μm或3μm厚作HGF或MGG染色,切片5μm厚作Gomori染色,必要时作Masson三色染色,按三种方法各染色1张切片。骨髓涂片行瑞特染色。结果：活检切片的诊断阳性率及判断骨髓增生度等较涂片明显为优。胶原纤维Masson三色染色呈阴性,提示骨髓转移癌并发骨髓纤维化,绝大多数为网硬蛋白型。结论：骨髓活检可作为诊断骨髓转移癌的常规检测手段,能够提高诊断率及评估疗效和预后。