{"id":48152,"date":"2025-02-26T05:11:04","date_gmt":"2025-02-26T05:11:04","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=48152"},"modified":"2025-02-26T05:11:04","modified_gmt":"2025-02-26T05:11:04","slug":"%e5%ad%a6%e7%90%86%e8%af%86%e7%90%86-%e8%a1%80%e6%b6%b2%e7%97%85%e7%90%86","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=48152","title":{"rendered":"\u5b66\u7406\u8bc6\u7406 | \u8840\u6db2\u75c5\u7406"},"content":{"rendered":"<h2 data-tool='mdnice\u7f16\u8f91\u5668'>1 \u53cd\u5e94\u6027\u6dcb\u5df4\u7ed3\u708e<\/h2>\n<h3 data-tool='mdnice\u7f16\u8f91\u5668'>1.1 &nbsp;\u6025\u6027\u975e\u7279\u5f02\u6027\u6dcb\u5df4\u7ed3\u708e(acute nonspecific lymphadenitis)<\/h3>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u5e38\u89c1\u4e8e\u5c40\u90e8\u611f\u67d3\u7684\u5f15\u6d41\u6dcb\u5df4\u7ed3<\/li>\n<li>\u5927\u4f53\uff1a\u80bf\u80c0\uff0c\u7070\u7ea2\uff0c\u5145\u8840<\/li>\n<li>\u955c\u4e0b\uff1a<\/li>\n<ul>\n<li>\u6dcb\u5df4\u6ee4\u6ce1\u589e\u751f<\/li>\n<li>\u751f\u53d1\u4e2d\u5fc3\u6269\u5927\uff0c\u8f83\u591a\u6838\u5206\u88c2<\/li>\n<li>\u5de8\u566c\u7ec6\u80de\u542b\u6709\u788e\u7247<\/li>\n<li>\u574f\u6b7b\u3001\u8113\u80bf\uff0c\u6216\u4e2d\u6027\u7c92\u7ec6\u80de\u6d78\u6da6<\/li>\n<li>\u7aa6\u5185\u76ae\u7ec6\u80de\u80a5\u5927\u589e\u751f<\/li>\n<\/ul>\n<\/ul>\n<h3 data-tool='mdnice\u7f16\u8f91\u5668'>1.2 \u6162\u6027\u975e\u7279\u5f02\u6027\u6dcb\u5df4\u7ed3\u708e(chronic nonspecific lymphadenitis)<\/h3>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u6dcb\u5df4\u6ee4\u6ce1\u589e\u751f\uff08\u9700\u4e0e\u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624(follicular lyphoma)\u9274\u522b\uff09<\/li>\n<ul>\n<li>\u6dcb\u5df4\u7ed3\u7ed3\u6784\u4ecd\u5b58\u5728\uff0c\u526f\u76ae\u8d28\u533a\u548c\u6dcb\u5df4\u7aa6\u53ef\u8fa8\u8ba4<\/li>\n<li>\u6dcb\u5df4\u5c0f\u7ed3\u5927\u5c0f\u548c\u5f62\u72b6\u5dee\u5f02\u5927\uff0c\u5957\u533a\u5b58\u5728<\/li>\n<li>\u751f\u53d1\u4e2d\u5fc3\u660e\u663e\u6269\u5927\uff0c\u6709\u6781\u6027\uff0c\u89c1\u4e0d\u7b49\u91cf\u7684\u4e2d\u5fc3\u6bcd\u7ec6\u80de\u548c\u4e2d\u5fc3\u7ec6\u80de\uff0c\u5206\u88c2\u8c61\u660e\u663e<\/li>\n<li>\u5de8\u566c\u7ec6\u80de\u542b\u6709\u788e\u7247<\/li>\n<li>BCL-2\u9634\u6027\uff0cki-67\u6709\u6781\u5411<\/li>\n<\/ul>\n<\/ul>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u526f\u76ae\u8d28\u533a\u589e\u751f\uff1aT\u7ec6\u80de\u533a\u589e\u751f<\/li>\n<li>\u7aa6\u7ec4\u7ec7\u7ec6\u80de\u589e\u751f\uff1a\u7aa6\u6269\u5f20\uff0c\u7ec4\u7ec7\u7ec6\u80de\u6570\u91cf\u589e\u52a0\u3001\u4f53\u79ef\u589e\u5927<\/li>\n<\/ul>\n<h2 data-tool='mdnice\u7f16\u8f91\u5668'>2 \u9ad3\u7cfb\u80bf\u7624<\/h2>\n<p>\u9aa8\u9ad3\u4e2d\u7684\u9020\u8840\u5e72\u7ec6\u80de\u53ef\u4ee5\u5411\u4e24\u4e2a\u65b9\u5411\u53d1\u751f\u514b\u9686\u6027\u589e\u751f\uff1a<\/p>\n<ul>\n<li>\u5411\u9ad3\u7ec6\u80de\u65b9\u5411\u514b\u9686\u6027\u589e\u751f\uff0c\u5f62\u6210\u7c92\u7ec6\u80de\u3001\u5355\u6838\u7ec6\u80de\u3001\u7ea2\u7ec6\u80de\u548c\u5de8\u6838\u7ec6\u80de\u7cfb\u522b\u7684\u80bf\u7624\uff0c\u7edf\u79f0\u4e3a\u9ad3\u7cfb\u80bf\u7624(myeloid neoplasms)\u3002<\/li>\n<li>\u5411\u6dcb\u5df4\u7ec6\u80de\u65b9\u5411\u514b\u9686\u6027\u589e\u751f\uff0c\u5f62\u6210\u6dcb\u5df4\u7ec4\u7ec7\u80bf\u7624(lymphoid neoplasms)\u3002<\/li>\n<\/ul>\n<p>\u767d\u8840\u75c5\u548c\u6dcb\u5df4\u7624\u540c\u5c5e\u4e8e\u6dcb\u5df4\u9020\u8840\u7cfb\u7edf\u7684\u6076\u6027\u80bf\u7624\u3002<\/p>\n<ul>\n<li>\u767d\u8840\u75c5(leukemia)\u7684\u7279\u5f81\u662f\u9aa8\u9ad3\u5185\u5f02\u5e38\u7684\u767d\u7ec6\u80de\u5f25\u6f2b\u6027\u589e\u751f\uff0c\u53d6\u4ee3\u6b63\u5e38\u9aa8\u9ad3\u7ec4\u7ec7\uff0c\u5e76\u8fdb\u5165\u5916\u5468\u8840\u548c\u6d78\u6da6\u809d\u3001\u813e\u3001\u6dcb\u5df4\u7ed3\u7b49\u5404\u7ec4\u7ec7\u5668\u5b98\u3002\u53ef\u4ee5\u662f\u9ad3\u7cfb\u80bf\u7624\uff08\u6025\u6027\u9ad3\u7cfb\u767d\u8840\u75c5AML\u3001\u6162\u6027\u9ad3\u7cfb\u767d\u8840\u75c5CML\uff09\uff0c\u4e5f\u53ef\u4ee5\u662f\u6dcb\u5df4\u7ec4\u7ec7\u80bf\u7624\uff08\u6025\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5ALL\u3001\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5CLL\uff09\u3002<\/li>\n<ul>\n<li>\u6025\u6027\u767d\u8840\u75c5\u7684\u7ec6\u80de\u5206\u5316\u505c\u6ede\u5728\u8f83\u65e9\u9636\u6bb5\uff0c\u591a\u4e3a\u539f\u59cb\u7ec6\u80de\u548c\u65e9\u5e7c\u7ec6\u80de\u3002\u8d77\u75c5\u6025\uff0c\u8fdb\u5c55\u5feb\uff0c\u591a\u53d1\u4e8e\u5e7c\u513f\u548c\u9752\u5c11\u5e74\u3002<\/li>\n<li>\u6162\u6027\u767d\u8840\u75c5\u7684\u7ec6\u80de\u5206\u5316\u505c\u6ede\u5728\u8f83\u665a\u9636\u6bb5\uff0c\u591a\u4e3a\u4e2d\u665a\u5e7c\u7ec6\u80de\u548c\u6210\u719f\u7ec6\u80de\u3002\u75c5\u60c5\u53d1\u5c55\u7f13\u6162\uff0c\u591a\u89c1\u4e8e\u6210\u4eba\u3002<\/li>\n<\/ul>\n<\/ul>\n<ul>\n<li>\u6dcb\u5df4\u7624(lymphoma)\u539f\u53d1\u4e8e\u6dcb\u5df4\u7ed3\u548c\u7ed3\u5916\u6dcb\u5df4\u7ec4\u7ec7\uff0c\u591a\u4e3a\u5b9e\u4f53\u7624\u3002\u4e00\u5b9a\u662f\u6dcb\u5df4\u7ec4\u7ec7\u80bf\u7624\uff0c\u5927\u591a\u6570\u662fB\u7ec6\u80de\u6e90\u6027\uff0c\u5176\u6b21\u4e3aT\/NK\u7ec6\u80de\u6e90\u6027\uff0c\u7ec4\u7ec7\u7ec6\u80de\u6e90\u6027\u7f55\u89c1\u3002\u53ef\u5206\u4e3a\u975e\u970d\u5947\u91d1\u6dcb\u5df4\u7624\u548c\u970d\u5947\u91d1\u6dcb\u5df4\u7624\u3002<\/li>\n<ul>\n<li>\u5728\u67d0\u4e9b\u975e\u970d\u5947\u91d1\u6dcb\u5df4\u7624\uff0c\u6dcb\u5df4\u7624\u548c\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5(lymphocytic leukemia)\u6709\u91cd\u53e0\uff1a\u5f53\u53ea\u8868\u73b0\u4e3a\u7624\u5757\u3001\u4e0d\u4f34\u6216\u4ec5\u6709\u8f7b\u5fae\u8840\u6db2\u548c\u9aa8\u9ad3\u53d7\u7d2f\u65f6\uff0c\u5e94\u89c6\u4e3a\u6dcb\u5df4\u7624\uff1b\u5f53\u5b58\u5728\u5e7f\u6cdb\u9aa8\u9ad3\u3001\u8840\u6db2\u53d7\u7d2f\u65f6\u8bca\u65ad\u4e3a\u6dcb\u5df4\u7ec6\u80de\u6027\u767d\u8840\u75c5\u66f4\u4e3a\u5408\u9002\u3002\u4e24\u8005\u4e3a\u540c\u4e00\u75be\u75c5\u7684\u4e0d\u540c\u53d1\u5c55\u9636\u6bb5\u3002<\/li>\n<\/ul>\n<\/ul>\n<h3 data-tool='mdnice\u7f16\u8f91\u5668'>2.1 \u6025\u6027\u9ad3\u7cfb\u767d\u8840\u75c5(acute myeloid leukemia, AML)<\/h3>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u539f\u59cb\u9ad3\u7cfb\u7ec6\u80de\u7684\u514b\u9686\u6027\u589e\u751f(colonal expansion of undifferentiated myeloid blasts)\uff0c\u53ef\u7d2f\u53ca\u4e00\u7cfb\u6216\u5168\u90e8\u7684\u9ad3\u7cfb\u7ec6\u80de\u3002\u7624\u7ec6\u80de\u505c\u6b62\u5728\u65e9\u671f\u9ad3\u7cfb\u5206\u5316\u9636\u6bb5\uff0c\u6b63\u5e38\u9aa8\u9ad3\u7ec4\u7ec7\u88ab\u76f8\u5bf9\u4e0d\u5206\u5316\u7684\u539f\u59cb\u7ec6\u80de\u53d6\u4ee3\u3002<\/li>\n<li>\u53ef\u53d1\u751f\u4e8e\u4efb\u4f55\u5e74\u9f84\uff0c\u591a\u89c1\u4e8e\u5e74\u8f7b\u4eba\uff0815~39\u5c81\uff09\u3002<\/li>\n<li>\u53ef\u539f\u53d1\uff0c\u6216\u7ee7\u53d1\u4e8e\u6162\u6027\u9aa8\u9ad3\u589e\u6b96\u6027\u75be\u75c5(CMPD)\u6216\u9aa8\u9ad3\u589e\u751f\u5f02\u5e38\u7efc\u5408\u5f81(MDS)\u3002<\/li>\n<li>FAB\u5206\u578b\uff1a\u6839\u636e\u7ec6\u80de\u5316\u5b66\u67d3\u8272\u548c\u5f62\u6001\u5206\u4e3aM0~M7\u3002\u4f8b\u5982\uff1a<\/li>\n<ul>\n<li>M0\uff08\u6025\u6027\u9ad3\u7cfb\u767d\u8840\u75c5\uff0c\u5fae\u5206\u5316\u578b\uff09<\/li>\n<li>M1\uff08\u6025\u6027\u9ad3\u7cfb\u767d\u8840\u75c5\uff0c\u672a\u5206\u5316\u578b\uff09<\/li>\n<li>M2\uff08\u6025\u6027\u9ad3\u7cfb\u767d\u8840\u75c5\uff0c\u90e8\u5206\u5206\u5316\u578b\uff09<\/li>\n<li>M3\uff08\u6025\u6027\u65e9\u5e7c\u7c92\u7ec6\u80de\u767d\u8840\u75c5\uff09<\/li>\n<\/ul>\n<li>\u5916\u5468\u8840\u6216\u9aa8\u9ad3\u6709\u6838\u7ec6\u80de\u4e2d\u539f\u59cb\u7ec6\u80de\u6bd4\u4f8b\u226520%\uff0c\u53ef\u8bca\u65adAML\u3002\u5e38\u6709\u55dc\u5929\u9752\u9897\u7c92\u548c\u5965\u6c0f\u5c0f\u4f53\u3002<\/li>\n<ul>\n<li>\u539f\u59cb\u7ec6\u80de\u5305\u62ec\u539f\u7c92\u7ec6\u80de(myeloblast)\u3001\u539f\u5355\u6838\u7ec6\u80de(monoblast)\u3001\u5e7c\u5355\u6838\u7ec6\u80de(promonocyte)\u3001\u6dcb\u5df4\u6bcd\u7ec6\u80de(lymphoblast)\u3002<\/li>\n<li>\u5965\u6c0f\u5c0f\u4f53(Auer rods)\uff1a\u53c8\u79f0\u68d2\u72b6\u5c0f\u4f53\uff0c\u662f\u767d\u7ec6\u80de\u6d46\u4e2d\u51fa\u73b0\u7d2b\u7ea2\u8272\u7ec6\u6746\u72b6\u7269\u8d28\u3002\u957f\u7ea61-6\u03bcm\uff0c1\u6761\u6216\u6570\u6761\u4e0d\u5b9a\u3002\u5728\u6025\u6027\u7c92\u7ec6\u80de\u6027\u767d\u8840\u75c5(M1\u3001M2)\u7684\u5e7c\u7a1a\u7c92\u7ec6\u80de\u6d46\u4e2d\u8f83\u4e3a\u591a\u89c1\uff0c\u5e38\u89c11-2\u6761\uff1b\u5728\u6025\u6027\u65e9\u5e7c\u7c92\u7ec6\u80de\u6027\u767d\u8840\u75c5(M3)\u4e2d\u53ef\u89c1\u6570\u6761\u81f3\u6570\u5341\u6761\uff0c\u6709\u4e9b\u5448\u675f\u72b6\uff1b\u6025\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\u4e2d\u4e0d\u51fa\u73b0\u3002<\/li>\n<\/ul>\n<\/ul>\n<p>\u5965\u6c0f\u5c0f\u4f53<\/p>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u5982\u679c\u60a3\u8005\u6709\u7279\u5f81\u6027\u7684\u9057\u4f20\u5b66\u5f02\u5e38\uff0c\u5373\u4f7f\u9aa8\u9ad3\u4e2d\u539f\u59cb\u7ec6\u80de\u8ba1\u6570&lt;20%\u4e5f\u5e94\u8bca\u65adAML\u3002\u4f8b\u5982\u67d3\u8272\u4f53\u6613\u4f4dt(15;17)(q22;q12)\u662fM3\u578b\u6240\u5177\u6709\u7684\u7279\u5f81\u6027\u67d3\u8272\u4f53\u6539\u53d8\uff0c\u4ea7\u751f\u4e86RAR\u03b1-PML\u878d\u5408\u57fa\u56e0\uff0c\u6291\u5236\u9020\u8840\u5e72\u7ec6\u80de\u7684\u6210\u719f\u5206\u5316\u3002<\/li>\n<li>\u8868\u73b0\u6b63\u5e38\u9aa8\u9ad3\u9020\u8840\u529f\u80fd\u53d7\u6291\u5236\u7684\u75c7\u72b6\uff0c\u5305\u62ec\u5404\u7c7b\u8840\u7ec6\u80de\u51cf\u5c11(pancytopenia)\u3001\u81ea\u53d1\u6027\u51fa\u8840\u3001DIC\u7b49\u3002\u9aa8\u75db\u662f\u767d\u8840\u75c5\u60a3\u8005\u7684\u5e38\u89c1\u8868\u73b0\u3002<\/li>\n<li>\u7eff\u8272\u7624(chloroma)\u5373\u9ad3\u7cfb\u8089\u7624(myeloid sarcoma)\uff0c\u662f\u9ad3\u7cfb\u539f\u59cb\u7ec6\u80de\u5728\u9aa8\u9ad3\u4ee5\u5916\u7684\u5668\u5b98\u6216\u7ec4\u7ec7\u5185\uff08\u9aa8\u819c\u4e0b\u3001\u8f6f\u7ec4\u7ec7\u5185\uff09\u805a\u96c6\u589e\u751f\u5f62\u6210\u7684\u80bf\u5757\u3002\u65b0\u9c9c\u65f6\u8089\u773c\u89c2\u5448\u7eff\u8272\u3002\u901a\u5e38\u7531\u539f\u59cb\u7c92\u7ec6\u80de\u7ec4\u6210\u3002\u4e0e\u6dcb\u5df4\u7624\u9274\u522b\uff0c\u9ad3\u8fc7\u6c27\u5316\u7269\u9176(myeloperoxidase, MPO)\u9633\u6027\u8868\u660e\u4e3a\u9ad3\u7cfb\u5206\u5316\u3002<\/li>\n<li>\u4f34\u6709t(15;17)(q22;q12)\u7684\u6025\u6027\u65e9\u5e7c\u7c92\u7ec6\u80de\u767d\u8840\u75c5\u5bf9\u5168\u53cd\u5f0f\u7ef4\u7532\u9178(ATRA)\u654f\u611f\uff0cAs2O3\u5bf9\u5176\u4e5f\u6709\u5f88\u597d\u7597\u6548\u3002<\/li>\n<li>\u9aa8\u9ad3\u79fb\u690d\u662f\u76ee\u524d\u53ef\u80fd\u6839\u6cbb\u767d\u8840\u75c5\u7684\u65b9\u6cd5\u3002<\/li>\n<\/ul>\n<h3 data-tool='mdnice\u7f16\u8f91\u5668'>2.2 \u6162\u6027\u9aa8\u9ad3\u589e\u6b96\u6027\u75be\u75c5(chronic myeloproliferative diseases, CMPD)<\/h3>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u5373\u9aa8\u9ad3\u589e\u6b96\u6027\u80bf\u7624(myeloproliferative neoplasms, MPN)\uff0c\u9aa8\u9ad3\u4e2d\u4e00\u7cfb\u6216\u4e00\u7cfb\u4ee5\u4e0a\u9ad3\u7cfb\u53d1\u751f\u589e\u6b96\uff0c\u6210\u719f\u5206\u5316\u76f8\u5bf9\u4e0d\u53d7\u5f71\u54cd\u3002\u5176\u7ed3\u679c\u662f\u9aa8\u9ad3\u9020\u8840\u589e\u52a0(hypercellular)\uff0c\u5916\u5468\u8840\u7ec6\u80de\u6570\u91cf\u663e\u8457\u589e\u591a(hematocytosis)\uff0c\u4f46\u5f62\u6001\u57fa\u672c\u6b63\u5e38\u3002<\/li>\n<li>\u5305\u62ec\u4ee5\u4e0b\u75be\u75c5\uff1a<\/li>\n<ul>\n<li>\u6162\u6027\u9ad3\u7cfb\u767d\u8840\u75c5(chronic myelogenous leukemia, CML)\uff0c\u5373\u6162\u6027\u7c92\u7ec6\u80de\u767d\u8840\u75c5<\/li>\n<li>\u771f\u6027\u7ea2\u7ec6\u80de\u589e\u591a\u75c7(polycythemia vera, PV)<\/li>\n<li>\u7279\u53d1\u6027\u8840\u5c0f\u677f\u589e\u591a\u75c7(essential thrombocythemia, ET)<\/li>\n<li>\u539f\u53d1\u6027\u9aa8\u9ad3\u7ea4\u7ef4\u5316(primary myelofibrosis, PMF)<\/li>\n<\/ul>\n<li>\u6240\u6709MPN\u60a3\u8005\u90fd\u6709\u4e0d\u540c\u7a0b\u5ea6\u7684\u813e\u810f\u80bf\u5927\u3002MPN\u540e\u671f\u53ef\u80fd\u53d1\u751f\u9aa8\u9ad3\u7ea4\u7ef4\u5316\u548c\u5916\u5468\u8840\u7ec6\u80de\u6570\u91cf\u51cf\u5c11\uff0c\u751a\u81f3\u8f6c\u5316\u4e3aAML\u3002<\/li>\n<\/ul>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>2.2.1 \u6162\u6027\u7c92\u7ec6\u80de\u767d\u8840\u75c5(CML)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u5b58\u5728\u7279\u5f81\u6027\u7684t(9;22)(q34;q11)\u6613\u4f4d\uff0c\u5f62\u6210\u8d39\u57ce\u67d3\u8272\u4f53(Ph)\uff0c\u5bfc\u81f4BCR-ABL1\u878d\u5408\u57fa\u56e0\u3002\u8be5\u57fa\u56e0\u7f16\u7801\u5177\u6709\u916a\u6c28\u9178\u6fc0\u9176\u6d3b\u6027\u7684\u878d\u5408\u86cb\u767d\u3002<\/li>\n<\/ul>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u4efb\u4f55\u5e74\u9f84\u5747\u53ef\u53d1\u75c5\uff0c\u591a\u89c1\u4e8e\u4e2d\u8001\u5e74\u4eba\u3002<\/li>\n<li>\u9aa8\u9ad3\u7ec6\u80de\u6027\u589e\u52a0\uff0c\u6709\u6838\u7ec6\u80de\u589e\u751f\u660e\u663e\u6d3b\u8dc3\uff0c\u53ef\u89c1\u5404\u5206\u5316\u9636\u6bb5\u7684\u7c92\u7ec6\u80de\uff0c\u4ee5\u5206\u53f6\u6838\u548c\u6746\u72b6\u6838\u7c92\u7ec6\u80de\u4e3a\u4e3b\uff0c\u5de8\u6838\u7ec6\u80de\u6570\u91cf\u589e\u52a0\uff08\u5c0f\u5de8\u6838\u7ec6\u80de\uff09\u3002\u53ef\u6709\u6d77\u84dd\u7ec4\u7ec7\u7ec6\u80de(sea-blue histiocytes)\u3002<\/li>\n<li>\u5916\u5468\u8840\u767d\u7ec6\u80de\u8ba1\u6570\u663e\u8457\u589e\u591a\uff0c\u4ee5\u4e2d\u3001\u665a\u5e7c\u548c\u6746\u72b6\u6838\u7c92\u7ec6\u80de\u5c45\u591a\u3002\u5e38\u6709\u55dc\u9178\u6027\u7c92\u7ec6\u80de\u548c\u55dc\u78b1\u6027\u7c92\u7ec6\u80de\u589e\u591a\uff0c\u7ea650%\u60a3\u8005\u5728\u80bf\u7624\u65e9\u671f\u6709\u8840\u5c0f\u677f\u589e\u591a\u3002\u53ef\u8868\u73b0\u8f7b\u5ea6\u81f3\u4e2d\u5ea6\u8d2b\u8840\u3002<\/li>\n<\/ul>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u813e\u810f\u660e\u663e\u80bf\u5927(splenomegaly)\uff0c\u809d\u810f\u548c\u6dcb\u5df4\u7ed3\u80bf\u5927\u8f83\u8f7b\u5fae\u3002<\/li>\n<li>\u591a\u6709\u4e4f\u529b\u3001\u4f4e\u70ed\u3001\u76d7\u6c57\u3001\u4f53\u91cd\u51cf\u8f7b\u7b49\u9ad8\u4ee3\u8c22\u7684\u8868\u73b0\u3002<\/li>\n<li>\u81ea\u7136\u75c5\u7a0b\u8868\u73b0\u4e3a\u6162\u6027\u671f\u3001\u52a0\u901f\u671f\u3001\u6025\u53d8\u671f\u6216\u5176\u4e2d\u7684\u4e24\u8005\u3002<\/li>\n<ul>\n<li>\u8d77\u75c5\u9690\u533f\uff0c\u8fdb\u5c55\u7f13\u6162\u3002<\/li>\n<li>\u672a\u52a0\u6cbb\u75973\u5e74\u540e\u7ea650%\u60a3\u8005\u8fdb\u5165\u52a0\u901f\u671f\uff0c\u57286~12\u4e2a\u6708\u540e\u8fdb\u5165\u6025\u53d8\u671f\uff0c\u5448\u6025\u6027\u767d\u8840\u75c5\u8868\u73b0\u3002\u53e6\u670950%\u60a3\u8005\u4e0d\u7ecf\u52a0\u901f\u671f\uff0c\u76f4\u63a5\u8fdb\u5165\u6025\u53d8\u671f\u3002<\/li>\n<li>\u6025\u53d8\u671f\u7ea670%\u7684\u75c5\u4f8b\u5448\u6025\u6027\u9ad3\u7cfb\u53d8\uff08\u7624\u7ec6\u80de\u4e3a\u539f\u59cb\u7c92\u7ec6\u80de\uff09\uff0c\u5c11\u6570\u5448\u6025\u6027\u6dcb\u7cfb\u53d8\uff08\u7624\u7ec6\u80de\u4e3a\u6dcb\u5df4\u6bcd\u7ec6\u80de\uff09\u3002\u8fd9\u5370\u8bc1\u4e86CML\u80bf\u7624\u7ec6\u80de\u8d77\u6e90\u4e8e\u9020\u8840\u5e72\u7ec6\u80de\u3002<\/li>\n<\/ul>\n<li>\u6cbb\u7597\u5305\u62ec\u5e72\u6270\u7d20\u03b1\u3001\u9776\u5411\u836f\u7269\u4f0a\u9a6c\u66ff\u5c3c\uff08imatinib)\u3001\u9aa8\u9ad3\u79fb\u690d\u7b49\u3002<\/li>\n<\/ul>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>2.2.2 \u539f\u53d1\u6027\u9aa8\u9ad3\u7ea4\u7ef4\u5316(primary myelofibrosis, PMF)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u4e3b\u8981\u8868\u73b0\u4e3a\u9aa8\u9ad3\u4e2d\u5de8\u6838\u7ec6\u80de\u548c\u7c92\u7ec6\u80de\u663e\u8457\u589e\u751f\u4f34\u53cd\u5e94\u6027\u7ea4\u7ef4\u7ed3\u7f14\u7ec4\u7ec7\u6c89\u79ef\uff08\u80f6\u539f\u7ea4\u7ef4\u3001\u7f51\u72b6\u7ea4\u7ef4\uff09\uff0c\u4f34\u9ad3\u5916\u9020\u8840\u3002<\/li>\n<li>\u75c5\u56e0\u662f\u5de8\u6838\u7ec6\u80de\u4e0d\u6070\u5f53\u5730\u91ca\u653e\u5982PDGF\u3001TGF-\u03b2\u7b49\u4e0e\u7ed3\u7f14\u7ec4\u7ec7\u589e\u751f\u76f8\u5173\u7684\u751f\u957f\u56e0\u5b50\u3002<\/li>\n<li>\u65e9\u671f\u4e3a\u7ec6\u80de\u589e\u751f\u671f(hypercellular stage)\uff0c\u665a\u671f\u4e3a\u7ea4\u7ef4\u5316\u671f(fibrotic stage)\u3002<\/li>\n<\/ul>\n<h3 data-tool='mdnice\u7f16\u8f91\u5668'>2.3 \u9aa8\u9ad3\u589e\u751f\u5f02\u5e38\u7efc\u5408\u5f81(myelodysplastic syndromes, MDS)<\/h3>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u514b\u9686\u6027\u9020\u8840\u5e72\u7ec6\u80de\u53d1\u80b2\u5f02\u5e38\uff0c\u7279\u5f81\u662f\u9aa8\u9ad3\u65e0\u6548\u9020\u8840(ineffective hematopoiesis)\u3001\u5916\u5468\u8840\u4e00\u7cfb\u6216\u591a\u7cfb\u8840\u7ec6\u80de\u51cf\u5c11(cytopenia)\u3002<\/li>\n<li>\u591a\u53d1\u4e8e\u8001\u5e74\u4eba\uff0860\u5c81\u4ee5\u4e0a\uff09\u3002<\/li>\n<li>\u51fa\u73b0\u8840\u7ec6\u80de\u51cf\u5c11\u76f8\u5e94\u75c7\u72b6\uff0c\u5982\u8d2b\u8840\u3001\u51fa\u8840\u3001\u611f\u67d3\u3002<\/li>\n<li>\u5206\u4e3a\u96be\u6cbb\u6027\u8d2b\u8840(refractory anemia, RA)\u3001\u73af\u5f62\u94c1\u7c92\u5e7c\u7ec6\u80de\u6027\u96be\u6cbb\u6027\u8d2b\u8840(RA with ringed sideroblasts)\u7b49\u7c7b\u578b\u3002<\/li>\n<li>\u7ec6\u80de\u9057\u4f20\u5b66\u6b63\u5e38\u3001\u5355\u7eaf\u4f34\u67095q-\u67d3\u8272\u4f53\u5f02\u5e38\uff0c\u9884\u540e\u826f\u597d\u3002\u5b58\u5728\u590d\u6742\u7684\u7ec6\u80de\u9057\u4f20\u5b66\u5f02\u5e38\uff0c\u9884\u540e\u5dee\u3002<\/li>\n<li>\u9ad8\u5371\u7ec4MDS\u9884\u540e\u8f83\u5dee\uff0c\u6613\u8f6c\u5316\u4e3aAML\uff0c\u9700\u8981\u9ad8\u5f3a\u5ea6\u6cbb\u7597\uff0c\u5305\u62ec\u5316\u7597\u548c\u79fb\u690d\u3002<\/li>\n<\/ul>\n<h2 data-tool='mdnice\u7f16\u8f91\u5668'>3 \u6dcb\u5df4\u7ec4\u7ec7\u80bf\u7624<\/h2>\n<p>\u6dcb\u5df4\u7ec4\u7ec7\u80bf\u7624(lymphoid neoplasms)\u6307\u6765\u6e90\u4e8e\u6dcb\u5df4\u7ec6\u80de\u53ca\u5176\u524d\u4f53\u7ec6\u80de\u7684\u6076\u6027\u80bf\u7624\uff0c\u5305\u62ec\u6dcb\u5df4\u7624\u3001\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\u3001\u6bdb\u7ec6\u80de\u767d\u8840\u75c5\u548c\u6d46\u7ec6\u80de\u80bf\u7624\u7b49\u3002<\/p>\n<p>\u6dcb\u5df4\u7624(lymphoma)\u539f\u53d1\u4e8e\u6dcb\u5df4\u7ed3\u548c\u7ed3\u5916\u6dcb\u5df4\u7ec4\u7ec7\uff0c\u591a\u4e3a\u5b9e\u4f53\u7624\u3002\u5927\u591a\u6570\u662fB\u7ec6\u80de\u6e90\u6027\uff0c\u5176\u6b21\u4e3aT\/NK\u7ec6\u80de\u6e90\u6027\uff0c\u7ec4\u7ec7\u7ec6\u80de\u6e90\u6027\u7f55\u89c1\u3002\u53ef\u5206\u4e3a\u975e\u970d\u5947\u91d1\u6dcb\u5df4\u7624\u548c\u970d\u5947\u91d1\u6dcb\u5df4\u7624\u3002<\/p>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u975e\u970d\u5947\u91d1\u6dcb\u5df4\u7624(non-Hodgkin lymphoma, NHL)\u5360\u6240\u6709\u6dcb\u5df4\u7624\u768480%~90%\uff0c2\/3\u539f\u53d1\u4e8e\u6dcb\u5df4\u7ed3\u3002\u80bf\u7624\u6027\u589e\u751f\u7684\u6dcb\u5df4\u7ec6\u80de\u53ef\u770b\u6210\u662f\u88ab\u963b\u65ad\u5728B\u7ec6\u80de\u6216T\u7ec6\u80de\u5206\u5316\u8fc7\u7a0b\u4e2d\u67d0\u4e00\u9636\u6bb5\u7684\u514b\u9686\u6027\u589e\u751f\u6240\u81f4\u3002\u6839\u636e\u80bf\u7624\u7ec6\u80de\u7684\u8d77\u6e90\u548c\u5c5e\u6027\u5206\u4e3a\u4e09\u5927\u7c7b\uff1a\u524d\u4f53B\u7ec6\u80de\u548cT\u7ec6\u80de\u80bf\u7624\u3001\u6210\u719f\uff08\u5916\u5468\uff09B\u7ec6\u80de\u80bf\u7624\u3001\u6210\u719f\uff08\u5916\u5468\uff09T\u7ec6\u80de\u548cNK\u7ec6\u80de\u80bf\u7624\u3002<\/li>\n<li>\u5728\u67d0\u4e9b\u975e\u970d\u5947\u91d1\u6dcb\u5df4\u7624\uff0c\u6dcb\u5df4\u7624\u548c\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5(lymphocytic leukemia)\u6709\u91cd\u53e0\uff1a\u5f53\u53ea\u8868\u73b0\u4e3a\u7624\u5757\u3001\u4e0d\u4f34\u6216\u4ec5\u6709\u8f7b\u5fae\u8840\u6db2\u548c\u9aa8\u9ad3\u53d7\u7d2f\u65f6\uff0c\u5e94\u89c6\u4e3a\u6dcb\u5df4\u7624\uff1b\u5f53\u5b58\u5728\u5e7f\u6cdb\u9aa8\u9ad3\u3001\u8840\u6db2\u53d7\u7d2f\u65f6\u8bca\u65ad\u4e3a\u6dcb\u5df4\u7ec6\u80de\u6027\u767d\u8840\u75c5\u66f4\u4e3a\u5408\u9002\u3002\u4e24\u8005\u4e3a\u540c\u4e00\u75be\u75c5\u7684\u4e0d\u540c\u53d1\u5c55\u9636\u6bb5\u3002<\/li>\n<li>\u970d\u5947\u91d1\u6dcb\u5df4\u7624(Hodgkin lymphoma, HL)\u539f\u53d1\u4e8e\u6dcb\u5df4\u7ed3\uff0c\u5176\u80bf\u7624\u7ec6\u80de\u662f\u4e00\u79cd\u72ec\u7279\u7684\u7624\u5de8\u7ec6\u80de\uff08R-S\u7ec6\u80de\uff09\u3002<\/li>\n<\/ul>\n<p>\u6dcb\u5df4\u7624\u662f\u5355\u514b\u9686\u7684\uff0c\u5373\u80bf\u7624\u6027\u7956\u7ec6\u80de\u4ea7\u751f\u7684\u6240\u6709\u5b50\u7ec6\u80de\u5177\u6709\u76f8\u540c\u7684\u6297\u539f\u53d7\u4f53\u57fa\u56e0\u5e8f\u5217\uff0c\u5408\u6210\u76f8\u540c\u7c7b\u578b\u7684\u514d\u75ab\u7403\u86cb\u767d\u6216T\u7ec6\u80de\u53d7\u4f53\u3002<\/p>\n<p>\u6dcb\u5df4\u7ec6\u80de\u7684\u514d\u75ab\u8868\u578b\uff1a<\/p>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>CD2\u30013\u30014\u30015\u30017\u30018\u7b49\u662fT\u7ec6\u80de\u7684\u6807\u5fd7\u3002<\/li>\n<ul>\n<li>CD2\u3001CD3\u8868\u8fbe\u4e8e\u5168\u90e8T\u7ec6\u80de\u8868\u9762\u3002CD7\u8868\u8fbe\u4e8e\u7edd\u5927\u591a\u6570\u7684\u5404\u4e2a\u5206\u5316\u9636\u6bb5\u7684T\u7ec6\u80de\u3002<\/li>\n<li>CD5\u8868\u8fbe\u4e8e\u80f8\u817a\u7ec6\u80de\u53ca\u968f\u540e\u5404\u9636\u6bb5\u7684\u7ec6\u80de\u3002<\/li>\n<li>CD4\u548cCD8\u5206\u5b50\u5206\u522b\u8868\u8fbe\u4e8e\u80f8\u817a\u9634\u6027\u9009\u62e9\u540e\u4e0d\u540c\u7684T\u7ec6\u80de\u4e9a\u7fa4\uff0c\u8868\u8fbeCD4\u7684\u4e3b\u8981\u662f\u8f85\u52a9\u6027T\u7ec6\u80de\uff0c\u8868\u8fbeCD8\u7684\u4e3b\u8981\u662f\u7ec6\u80de\u6bd2\u6027T\u7ec6\u80de\u3002<\/li>\n<\/ul>\n<\/ul>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>CD19\u3001CD20\u3001CD79a\u3001PAX5\u7b49\u662fB\u7ec6\u80de\u7684\u6807\u5fd7\u3002<\/li>\n<ul>\n<li>CD19\u3001PAX5\u8868\u8fbe\u4e8e\u9664\u6d46\u7ec6\u80de\u5916\u7684\u5404\u9636\u6bb5B\u7ec6\u80de\u8868\u9762\u3002<\/li>\n<li>CD20\u5b58\u5728\u4e8e\u665a\u671f\u524dB\u7ec6\u80de\u548c\u6210\u719fB\u7ec6\u80de\uff0c\u4e0d\u8868\u8fbe\u4e8e\u6d46\u7ec6\u80de\u3002<\/li>\n<li>CD79a\u8868\u8fbe\u4e8e\u5404\u9636\u6bb5B\u7ec6\u80de\u3002<\/li>\n<\/ul>\n<\/ul>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u672a\u6210\u719f\u7684B\u548cT\u7ec6\u80de\u8868\u8fbeTdT\uff08\u672b\u7aef\u8131\u6c27\u6838\u82f7\u9178\u8f6c\u79fb\u9176\uff1b\u521d\u59cbB\u7ec6\u80de\u4e4b\u524d\u3001\u5916\u5468T\u7ec6\u80de\u4e4b\u524d\uff09\uff0c\u533a\u522b\u4e8e\u6210\u719f\u7684\u6dcb\u5df4\u7ec6\u80de\u80bf\u7624\u3002<\/li>\n<li>CD56\u662fNK\u7ec6\u80de\u7684\u6807\u5fd7\u3002<\/li>\n<\/ul>\n<h3 data-tool='mdnice\u7f16\u8f91\u5668'>3.1 \u524d\u4f53B\u7ec6\u80de\u548cT\u7ec6\u80de\u80bf\u7624(precursor B-cell and T-cell neoplasms)<\/h3>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u5373\u6025\u6027\u6dcb\u5df4\u6bcd\u7ec6\u80de\u767d\u8840\u75c5\/\u6dcb\u5df4\u7624(acute lymphoblastic leukemia\/lymphoma, ALL)\uff0c\u662f\u4e0d\u6210\u719f\u7684\u524d\u4f53B\u7ec6\u80de\u6216\u524d\u4f53T\u7ec6\u80de\u6765\u6e90\u7684\u9ad8\u5ea6\u4fb5\u88ad\u6027\u80bf\u7624\u3002\u5305\u62ec\u4e24\u79cd\u7c7b\u578b\uff1a<\/li>\n<ul>\n<li>B-ALL\uff1a\u60a3\u8005\u591a\u4e3a\u513f\u7ae5\uff0c\u5e38\u8868\u73b0\u767d\u8840\u75c5\uff0c\u6709\u5e7f\u6cdb\u7684\u9aa8\u9ad3\u7d2f\u53ca\u548c\u5916\u5468\u8840\u767d\u7ec6\u80de\u6570\u91cf\u589e\u52a0\u3002<\/li>\n<li>T-ALL\uff1a\u591a\u89c1\u4e8e\u9752\u5c11\u5e74\u7537\u6027\uff0c\u8868\u73b0\u4e3a\u5c40\u90e8\u5305\u5757\uff0c\u7d2f\u53ca\u80f8\u817a\u3002<\/li>\n<\/ul>\n<li>\u591a\u6570\u60a3\u8005\u7684\u5e74\u9f84\u572815\u5c81\u4ee5\u4e0b\uff0c\u75c5\u60c5\u8fdb\u5c55\u8fc5\u901f\u3002\u53ef\u6709\u8d2b\u8840\u3001\u7c92\u7ec6\u80de\u548c\u8840\u5c0f\u677f\u51cf\u5c11\u3001\u51fa\u8840\u548c\u7ee7\u53d1\u611f\u67d3\u7b49\uff0c\u5e38\u6709\u6dcb\u5df4\u7ed3\u80bf\u5927\u3001\u813e\u5927\u3001\u809d\u80bf\u5927\uff0c\u53ef\u7d2f\u53ca\u777e\u4e38(testis)\u3001\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u3002<\/li>\n<li>\u8868\u8fbe\u539f\u59cb\u6dcb\u5df4\u7ec6\u80de\u6807\u8bb0TdT\u548cCD34\uff0c\u4ee5\u53caB\u6216T\u7ec6\u80de\u6297\u539f\u3002<\/li>\n<li>\u5bf9\u6cbb\u7597\u53cd\u5e94\u5f88\u654f\u611f\uff0c\u5f3a\u529b\u5316\u7597\u53ef\u7f13\u89e3\u30022~10\u5c81\uff0c\u8d85\u4e8c\u500d\u4f53(hyperploidy)\u548ct(12;21) \u9884\u540e\u597d\uff1b&lt;2\u5c81\u6216&gt;10\u5c81\uff0c\u4e9a\u4e8c\u500d\u4f53(hypoploidy)\u548ct(9;22)\uff0c\u9884\u540e\u5dee\u3002<\/li>\n<\/ul>\n<h3 data-tool='mdnice\u7f16\u8f91\u5668'>3.2 \u6210\u719fB\u7ec6\u80de\u80bf\u7624(mature B-cell neoplasms)<\/h3>\n<p>\u7ea680%\u7684NHL\u662f\u6210\u719fB\u7ec6\u80de\u80bf\u7624\uff0c\u6839\u636e\u5b83\u4eec\u5047\u5b9a\u7684\u7ec6\u80de\u8d77\u6e90\u5206\u4e3a\u82e5\u5e72\u7c7b\u578b\u3002\u6700\u5e38\u89c1\u7684\u662f\u5f25\u6f2b\u6027\u5927B\u7ec6\u80de\u6dcb\u5df4\u7624(DLBCL)\u548c\u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624(FL)\u3002<\/p>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>3.2.1 \u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\/\u5c0f\u6dcb\u5df4\u7ec6\u80de\u6dcb\u5df4\u7624(chronic lymphocytic leukemia\/small lymphocytic lymphoma, CLL\/SLL)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u6210\u719fB\u7ec6\u80de\u6765\u6e90\u7684\u60f0\u6027\u80bf\u7624\u3002<\/li>\n<li>CLL\uff1a\u5916\u5468\u8840\u767d\u7ec6\u80de\u663e\u8457\u589e\u591a\uff0c\u7edd\u5927\u591a\u6570\u4e3a\u6210\u719f\u7684\u5c0f\u6dcb\u5df4\u7ec6\u80de\u3002\u8bca\u65ad\u8981\u6c42CD5 \u80bf\u7624\u6027B\u6dcb\u5df4\u7ec6\u80de\u2265\/L\u3002<\/li>\n<li>SLL\uff1a\u6dcb\u5df4\u7ed3\u7ec4\u7ec7\u5c0f\u6dcb\u5df4\u7ec6\u80de\u5f25\u6f2b\u578b\u6d78\u6da6\uff0c\u90e8\u5206\u4f53\u79ef\u7a0d\u5927\u7684\u5e7c\u6dcb\u5df4\u7ec6\u80de\u805a\u96c6\u5728\u4e00\u8d77\uff0c\u5f62\u6210\u6de1\u67d3\u7684\u201c\u589e\u6b96\u4e2d\u5fc3\u201d\u3002<\/li>\n<li>\u8868\u8fbeB\u7ec6\u80de\u6807\u8bb0CD19\u3001CD20\uff0c\u901a\u5e38\u8868\u8fbeCD5\u3001CD23\uff08\u751f\u53d1\u4e2d\u5fc3\u7684\u6d3b\u5316B\u7ec6\u80de\uff09\u3002\u4e0d\u8868\u8fbeCD10\uff08\u672a\u6210\u719fB\u7ec6\u80de\u3001\u751f\u53d1\u4e2d\u5fc3B\u7ec6\u80de\uff09\u3002<\/li>\n<li>\u5e38\u89c112\u53f7\u67d3\u8272\u4f53\u4e09\u500d\u4f53(trisomy 12)\u300113q\u7f3a\u5931\u7b49\u3002<\/li>\n<li>\u5e38\u89c1\u4e8e50\u5c81\u4ee5\u4e0a\u8001\u5e74\u4eba\uff0c\u7537\u6027\u660e\u663e\u591a\u4e8e\u5973\u6027\uff0c\u8fdb\u5c55\u7f13\u6162\uff0c\u4e00\u822c\u65e0\u81ea\u89c9\u75c7\u72b6\u3002<\/li>\n<li>\u9884\u540e\u4e3b\u8981\u4e0e\u4e34\u5e8a\u5206\u671f\u6709\u5173\u3002\u968f\u7740\u75c5\u60c5\u8fdb\u5c55\uff0c\u5c11\u90e8\u5206\u60a3\u8005\u8fdb\u5c55\u4e3a\u5e7c\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\u6216\u5f25\u6f2b\u6027\u5927B\u7ec6\u80de\u6dcb\u5df4\u7624\u3002\u8f6c\u5316\u540e\u60a3\u8005\u7684\u9884\u540e\u4e0d\u826f\u3002<\/li>\n<\/ul>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>3.2.2 \u6ee4\u6ce1\u6027\u6dcb\u5df4\u7624(follicular lymphoma, FL)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u6ee4\u6ce1\u4e2d\u5fc3B\u7ec6\u80de\u53d1\u751f\u7684\u6dcb\u5df4\u7624\uff0c\u60f0\u6027\u8fc7\u7a0b\u3002<\/li>\n<li>\u591a\u89c1\u4e8e\u4e2d\u8001\u5e74\u4eba\uff0c\u4e2d\u4f4d\u5e74\u9f8459\u5c81\u3002\u4e3b\u8981\u8868\u73b0\u4e3a\u5c40\u90e8\u6216\u5168\u8eab\u6dcb\u5df4\u7ed3\u65e0\u75db\u6027\u80bf\u5927\uff0c\u4ee5\u8179\u80a1\u6c9f\u6dcb\u5df4\u7ed3(inguinal lymph nodes)\u53d7\u7d2f\u591a\u89c1\u3002\u5e38\u6709\u813e\u5927\uff0c40%\u7684\u60a3\u8005\u9aa8\u9ad3\u53d7\u7d2f\u3002<\/li>\n<li>t(14;18)(q32;q21)\u67d3\u8272\u4f53\u6613\u4f4d\u662fFL\u7684\u7279\u5f81\u6027\u7ec6\u80de\u9057\u4f20\u5b66\u6539\u53d8\uff0c\u5bfc\u81f4Bcl2\/IgH\u878d\u5408\u57fa\u56e0\uff0c\u8868\u8fbeBcl2\u86cb\u767d\uff0c\u5177\u6709\u6297\u51cb\u4ea1\u4f5c\u7528\u3002<\/li>\n<li>\u6b63\u5e38\u6ee4\u6ce1\u751f\u53d1\u4e2d\u5fc3B\u7ec6\u80de\u4e3aBcl2\u9634\u6027\uff0c\u7531\u6b64\u53ef\u533a\u5206\u6ee4\u6ce1\u53cd\u5e94\u6027\u589e\u751f\u548c\u80bf\u7624\u6027\u589e\u751f\u3002<\/li>\n<li>\u8868\u8fbeCD19\u3001CD20\u3001CD10\u3001Bcl2\u3001Bcl6\u3001\u5355\u514b\u9686\u6027\u7684\u8868\u9762Ig\uff0c\u4e0d\u8868\u8fbeCD5\u3002<\/li>\n<li>\u75c5\u7406\u53d8\u5316\uff1a<\/li>\n<ul>\n<li>\u6dcb\u5df4\u7ed3\u7ed3\u6784\u7834\u574f\uff0c\u5f62\u6210\u6ee4\u6ce1\u72b6\u7ed3\u6784\u3002<\/li>\n<li>\u6ee4\u6ce1\u5927\u5c0f\u8f83\u4e00\u81f4\uff0c\u6392\u5217\u62e5\u6324\u3002<\/li>\n<li>\u5957\u533a\u53d8\u8584\u6216\u6d88\u5931\uff0c\u5957\u533a\u4e0e\u751f\u53d1\u4e2d\u5fc3\u754c\u9650\u4e0d\u6e05\u3002<\/li>\n<li>\u751f\u53d1\u4e2d\u5fc3\u6781\u5411\u6d88\u5931\u3002<\/li>\n<li>\u661f\u7a7a\u73b0\u8c61\u6d88\u5931\uff08\u4e0d\u89c1\u5de8\u566c\u7ec6\u80de\u541e\u566c\u51cb\u4ea1\u7ec6\u80de\u788e\u7247\uff09\u3002<\/li>\n<li>\u80bf\u7624\u6027\u6ee4\u6ce1\u4e3b\u8981\u7531\u4e2d\u5fc3\u6bcd\u7ec6\u80de\uff08\u4f53\u79ef\u5927\uff0c\u67091~3\u4e2a\u5c0f\u6838\u4ec1\uff09\u548c\u4e2d\u5fc3\u7ec6\u80de\uff08\u4f53\u79ef\u5c0f\uff0c\u6838\u4ec1\u4e0d\u660e\u663e\uff09\u4ee5\u4e0d\u540c\u6bd4\u4f8b\u7ec4\u6210\u3002\u6839\u636e\u663e\u5fae\u955c\u89c6\u91ce\u4e2d\u7684\u4e2d\u5fc3\u6bcd\u7ec6\u80de\u6570\u91cf\u5206\u4e3a1~3\u7ea7\u3002<\/li>\n<\/ul>\n<\/ul>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>3.2.3 \u5957\u7ec6\u80de\u6dcb\u5df4\u7624(mantle cell lymphoma)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u6dcb\u5df4\u7ed3\u80bf\u5927\uff0c\u7ecf\u5e38\u4f34\u968f\u5168\u8eab\u75c7\u72b6\u3002<\/li>\n<li>\u60f0\u6027\u6216\u4fb5\u88ad\u6027\u3002\u7ed3\u5916\u5668\u5b98\u53ef\u80fd\u88ab\u7d2f\u53ca\uff0c\u4f8b\u5982\u5927\u80a0\u6709\u6dcb\u5df4\u7624\u6027\u606f\u8089\u75c5\u53d8(lymphomatois polyposis)\u3002<\/li>\n<li>\u4ee5t(11,14)(q13;q32)\u548ccyclin D1(Bcl1)\u8fc7\u5ea6\u8868\u8fbe\u4e3a\u7279\u5f81\uff08\u5f62\u6210Bcl1\/IgH\u878d\u5408\u57fa\u56e0\uff0c\u8868\u8fbeBcl1\u86cb\u767d\uff09\u3002<\/li>\n<li>CD20 \uff0cCD5 \uff0cCD10-\uff0cCD23-\u3002<\/li>\n<\/ul>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>3.2.4 \u8fb9\u7f18\u533aB\u7ec6\u80de\u6dcb\u5df4\u7624(marginal zone B-cell lymphoma)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u5206\u4e3a\u813e\u810f(splenic)\u3001\u6dcb\u5df4\u7ed3(nodal)\u548c\u7ed3\u5916\uff08\u9ecf\u819c\u76f8\u5173\u6dcb\u5df4\u7ec4\u7ec7\uff0cMALT\uff09\u8fb9\u7f18\u533aB\u7ec6\u80de\u6dcb\u5df4\u7624\u4e09\u7c7b\u3002<\/li>\n<li>MALT\u6dcb\u5df4\u7624\u5e38\u6709\u6162\u6027\u708e\u75c7\u3001\u81ea\u8eab\u514d\u75ab\u75c5\u6216\u7279\u6b8a\u75c5\u539f\u5fae\u751f\u7269\u611f\u67d3\u7b49\u57fa\u7840\u75be\u75c5\u3002\u53d1\u75c5\u90e8\u4f4d\u4ee5\u80c3\u80a0\u9053\u591a\u89c1\uff0c\u4e0eHP\u611f\u67d3\u6709\u5173\u3002\u6297HP\u6cbb\u7597\u5bf9HP\u76f8\u5173\u80c3MALT\u6dcb\u5df4\u7624\u53ef\u8fbe\u5230\u957f\u671f\u7f13\u89e3\u3002<\/li>\n<li>CD20 \u3001CD79a \uff0cCD5-\u3001CD10-\u3001CD23-\u3001cyclin D1-\u3002<\/li>\n<li>t(11;18)\u6613\u4f4d\u662f\u5e38\u89c1\u7684\u7279\u5f81\u6027\u6539\u53d8\u3002<\/li>\n<li>MALT\u6dcb\u5df4\u7624\u7684\u75c5\u53d8\u7279\u70b9\uff1a<\/li>\n<ul>\n<li>\u80bf\u7624\u7ec6\u80de\u5e38\u89c1\u4e8e\u6dcb\u5df4\u6ee4\u6ce1\u5957\u533a\u7684\u5916\u4fa7\u3002<\/li>\n<li>\u7624\u7ec6\u80de\u4e3b\u8981\u662f\u5c0f\u5230\u4e2d\u7b49\u5927\u5c0f\u7684\u6dcb\u5df4\u7ec6\u80de\uff0c\u6838\u5f62\u6001\u4e0d\u89c4\u5219\u3002<\/li>\n<li>\u7624\u7ec6\u80de\u5e38\u4fb5\u5165\u817a\u4f53\u4e0a\u76ae\u7ec4\u7ec7\uff0c\u5f62\u6210\u6dcb\u5df4\u4e0a\u76ae\u75c5\u53d8(lymphoepithelial lesion)\u3002<\/li>\n<li>\u5e38\u89c1\u6d46\u7ec6\u80de\u5206\u5316\u3002<\/li>\n<li>\u6709\u65f6\u7624\u7ec6\u80de\u4fb5\u5165\u751f\u53d1\u4e2d\u5fc3\uff0c\u5f62\u6210\u6ee4\u6ce1\u5185\u690d\u5165\u73b0\u8c61\u3002<\/li>\n<\/ul>\n<li>\u597d\u53d1\u4e8e\u8001\u5e74\uff0c\u4e2d\u4f4d\u5e74\u9f84&gt;60\u5c81\u3002\u5bf9\u653e\u7597\u654f\u611f\u3002\u5177\u6709\u60f0\u6027\u7684\u4e34\u5e8a\u8fc7\u7a0b\uff0c\u591a\u6570\u9884\u540e\u826f\u597d\u3002<\/li>\n<\/ul>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>3.2.5 \u6d46\u7ec6\u80de\u9aa8\u9ad3\u7624(plasma cell myeloma)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u5373\u591a\u53d1\u6027\u9aa8\u9ad3\u7624(multiple myeloma)\uff0c\u4ee5\u591a\u7076\u6027\u9aa8\u9ad3\u53d7\u7d2f\u4e3a\u7279\u5f81\uff0c\u53ef\u64ad\u6563\u5230\u6dcb\u5df4\u7ed3\u548c\u7ed3\u5916\u5668\u5b98\u6216\u7ec4\u7ec7\u3002<\/li>\n<li>\u7279\u5f81\u6027\u75c5\u7406\u53d8\u5316\u662f\u5168\u8eab\u9aa8\u9ad3\u7cfb\u7edf\u7684\u591a\u53d1\u6027\u6eb6\u9aa8\u6027\u75c5\u53d8\uff0c\u5176\u5185\u5145\u6ee1\u8d28\u8f6f\u3001\u80f6\u51bb\u72b6\u3001\u9c7c\u8089\u6837\u7684\u80bf\u7624\u7ec4\u7ec7\u3002<\/li>\n<li>\u591a\u53d1\u751f\u4e8e\u4e2d\u8001\u5e74\u4eba\uff0c\u4e34\u5e8a\u8868\u73b0\u5305\u62ec\u5e7f\u6cdb\u9aa8\u9ad3\u7834\u574f\u5f15\u8d77\u9aa8\u75db\u3001\u75c5\u7406\u6027\u9aa8\u6298\uff0c\u8d2b\u8840\u3001\u767d\u7ec6\u80de\u548c\u8840\u5c0f\u677f\u51cf\u5c11\uff0c\u6b63\u5e38\u4f53\u6db2\u514d\u75ab\u53d7\u6291\u5236\u5f15\u8d77\u53cd\u590d\u611f\u67d3\uff0c\u80be\u8870\u7aed\uff0cBence Jones\u86cb\u767d\u5c3f(proteinuria)\uff0c\u539f\u53d1\u6027\u6dc0\u7c89\u6837\u53d8\u6027(primary amyloidosis)\u7b49\u3002<\/li>\n<li>CD79a \u3001CD38 \u3001CD138 \uff0cCD19-\u3001CD20-\u3002<\/li>\n<li>t(11;14)\u662f\u6700\u5e38\u68c0\u6d4b\u5230\u7684(15-20%)\u7ec6\u80de\u9057\u4f20\u5b66\u5f02\u5e38\u3002<\/li>\n<\/ul>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>3.2.6 \u5f25\u6f2b\u5927B\u7ec6\u80de\u6dcb\u5df4\u7624(diffuse large B cell lymphoma, DLBCL)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u6700\u5e38\u89c1\u7684\u975e\u970d\u5947\u91d1\u6dcb\u5df4\u7624\uff0c\u4fb5\u88ad\u6027\uff0c\u5e38\u5728\u77ed\u671f\u5185\u51fa\u73b0\u5355\u4e2a\u6216\u591a\u4e2a\u6dcb\u5df4\u7ed3\u80bf\u5927\u6216\u7ed3\u5916\u80bf\u5757\u3002<\/li>\n<li>\u7ec4\u7ec7\u5b66\u5f62\u6001\u53d8\u5f02\u5927\uff0c\u57fa\u672c\u7ec4\u7ec7\u5b66\u8868\u73b0\u4e3a\u5f62\u6001\u76f8\u5bf9\u5355\u4e00\u3001\u4f53\u79ef\u8f83\u5927\u7684\u5f02\u578b\u6dcb\u5df4\u7ec6\u80de\u5f25\u6f2b\u6d78\u6da6\u3002<\/li>\n<li>\u8868\u8fbeB\u7ec6\u80de\u5206\u5316\u6297\u539fCD19\u3001CD20\u548cCD79a\u3002\u90e8\u5206\u51fa\u73b0BCL2\u57fa\u56e0\u6613\u4f4d\/MYC\u57fa\u56e0\u6613\u4f4d\/BCL6\u57fa\u56e0\u6613\u4f4d\u3002\u540c\u65f6\u9ad8\u8868\u8fbeMyc\u548cBcl2\u86cb\u767d\u7684DLBCL\u9884\u540e\u8f83\u5dee\u3002<\/li>\n<li>\u53ef\u5206\u4e3a\u751f\u53d1\u4e2d\u5fc3B\u7ec6\u80de\u6765\u6e90\u7684DLBCL\uff08CD20 \uff0cBcl6 \uff0cCD10\u00b1\uff0cMUM1-\uff09\u548c\u6d3b\u5316B\u7ec6\u80de\u6765\u6e90\u7684DLBCL\uff08CD20 \uff0cBcl6\u00b1\uff0cCD10-\uff0cMUM1 \uff09\u3002<\/li>\n<li>\u5bf9\u5316\u7597\u654f\u611f\uff0c\u7ea650%\u53ef\u4e34\u5e8a\u6cbb\u6108\u3002\u6297B\u7ec6\u80deCD20\u7684\u5229\u59a5\u6614\u5355\u6297(Rituximab)\u4e0e\u5316\u7597\u65b9\u6848\u8054\u5408\u4f7f\u7528\u663e\u8457\u6539\u5584\u9884\u540e\u3002<\/li>\n<\/ul>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>3.2.7 Burkitt\u6dcb\u5df4\u7624<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u6dcb\u5df4\u6ee4\u6ce1\u751f\u53d1\u4e2d\u5fc3\u7ec6\u80de\u6216\u751f\u53d1\u4e2d\u5fc3\u540eB\u7ec6\u80de\u8d77\u6e90\u7684\u9ad8\u5ea6\u4fb5\u88ad\u6027\u80bf\u7624\u3002<\/li>\n<li>\u5206\u4e3a\u5730\u65b9\u6027(endemic)\uff08\u4e0eEB\u75c5\u6bd2\u611f\u67d3\u5bc6\u5207\u76f8\u5173\uff09\u3001\u6563\u53d1\u6027(sporadic)\u3001\u514d\u75ab\u7f3a\u9677\u76f8\u5173\u6027\uff08\u5e38\u89c1\u4e8eHIV\u611f\u67d3\u8005\uff09\u3002<\/li>\n<li>\u7624\u7ec6\u80de\u4e4b\u95f4\u6563\u5728\u5206\u5e03\u7740\u80de\u8d28\u4e30\u5bcc\u800c\u900f\u4eae\u7684\u53cd\u5e94\u6027\u5de8\u566c\u7ec6\u80de\uff0c\u6784\u6210\u6ee1\u5929\u661f\u56fe\u50cf(starry sky)\uff0c\u80de\u8d28\u5185\u6709\u88ab\u541e\u566c\u7684\u7ec6\u80de\u6838\u788e\u7247\u3002<\/li>\n<li>\u7624\u7ec6\u80de\u8868\u8fbeB\u7ec6\u80de\u5206\u5316\u6297\u539fCD19\u3001CD20\u3001CD79a\uff0c\u8868\u8fbe\u6ee4\u6ce1\u751f\u53d1\u4e2d\u5fc3\u7ec6\u80de\u6807\u8bb0Bcl6\u3001CD10\uff0c\u4e0d\u8868\u8fbeCD5\u3001CD23\u3001TdT\u3002Ki67\u67d3\u8272\u51e0\u4e4e100%\u9633\u6027\u3002<\/li>\n<li>\u5927\u90fd\u5b58\u5728\u4e0e\u7b2c8\u53f7\u67d3\u8272\u4f53\u4e0aMyc\u57fa\u56e0\u6709\u5173\u7684\u6613\u4f4d\uff0c\u6700\u5e38\u89c1\u7684\u662ft(9;14)(q24;32)\uff0c\u5bfc\u81f4Myc-IgH\u878d\u5408\u57fa\u56e0\u3002<\/li>\n<li>\u591a\u89c1\u4e8e\u513f\u7ae5\u548c\u9752\u5e74\u4eba\u3002\u5730\u65b9\u6027BL\u5e38\u53d1\u751f\u4e8e\u7ed3\u5916\uff0c\u53ef\u7d2f\u53ca\u988c\u9aa8(jaw)\uff0c\u8868\u73b0\u4e3a\u988c\u9762\u90e8\u5de8\u5927\u5305\u5757\u3002\u6563\u53d1\u6027BL\u5e38\u53d1\u751f\u5728\u56de\u76f2\u90e8(ileocecum)\uff0c\u8868\u73b0\u4e3a\u8179\u8154\u5185\u5de8\u5927\u80bf\u7269\u3002<\/li>\n<li>\u6025\u75c7\uff0c\u9700\u5c3d\u65e9\u8bca\u65ad\u548c\u6cbb\u7597\u3002\u5bf9\u77ed\u671f\u5927\u5242\u91cf\u5316\u7597\u53cd\u5e94\u597d\uff0c\u591a\u6570\u9884\u540e\u597d\u3002<\/li>\n<\/ul>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>3.2.8 \u6bdb\u7ec6\u80de\u767d\u8840\u75c5(hairy cell leukemia)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u4e2d\u4f4d\u5e74\u9f8455\u5c81\uff0c\u7537\u6027\u591a\u53d1\u3002<\/li>\n<li>\u5168\u8840\u7ec6\u80de\u51cf\u5c11(pancytopenia)\uff0c\u813e\u810f\u80bf\u5927(splenomegaly)\uff0c\u53ca\u5916\u5468\u8840\u53ca\u9aa8\u9ad3\u51fa\u73b0\u5927\u91cf\u8fb9\u7f18\u4e0d\u6574\u9f50\u5448\u4f2a\u8db3\u72b6\u6216\u7ea4\u6bdb\u6837\u7a81\u51fa\u7684\u767d\u7ec6\u80de\uff08\u89c1\u4e0b\u56fe\uff09\u3002<\/li>\n<li>\u5355\u6838\u7ec6\u80de\u660e\u663e\u51cf\u5c11(monocytopenia)\u3002<\/li>\n<li>CD20 \uff0cCD5-\uff0cCD10-\uff0cCD23-\u3002\u63a8\u6d4b\u6bdb\u7ec6\u80de\u4e3a\u5206\u5316\u963b\u6ede\u5728\u6162\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\u4e0e\u591a\u53d1\u6027\u9aa8\u9ad3\u7624\u4e4b\u95f4\u7684\u6bd4\u8f83\u6210\u719f\u7684B\u7ec6\u80de\u9636\u6bb5\u3002<\/li>\n<li>\u9178\u6027\u78f7\u9178\u9176\u9633\u6027\u4e0d\u88ab\u9152\u77f3\u9178\u76d0\u6240\u6291\u5236(tartrate resistant acid phosphatase, TRAP)\u3002<\/li>\n<li>\u8fdb\u5c55\u7f13\u6162\uff0c\u6709\u53ef\u80fd\u957f\u671f\u7f13\u89e3\u3002\u813e\u5207\u9664(splenectomy)\u53ef\u80fd\u5ef6\u957f\u751f\u5b58\u671f\u3002<\/li>\n<\/ul>\n<h3 data-tool='mdnice\u7f16\u8f91\u5668'>3.3\u6210\u719fT\u7ec6\u80de\u548cNK\u7ec6\u80de\u80bf\u7624(mature T-cell and NK-cell neoplasms)<\/h3>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>NK\u7ec6\u80de\u4e0eT\u7ec6\u80de\u5bc6\u5207\u76f8\u5173\uff0c\u5e76\u4e14\u5177\u6709\u90e8\u5206\u76f8\u540c\u7684\u514d\u75ab\u8868\u578b\u548c\u529f\u80fd\u7279\u6027\u3002<\/li>\n<li>\u4e0eB\u7ec6\u80de\u80bf\u7624\u76f8\u6bd4\uff0c\u9884\u540e\u4e0d\u826f\uff0c\u6709\u4fb5\u88ad\u6027\uff0c\u6cbb\u7597\u53cd\u5e94\u5dee\u3002<\/li>\n<li>\u8548\u6837\u9709\u83cc\u75c5(mycosis fungoides, MF)\uff1a\u4e00\u79cd\u539f\u53d1\u4e8e\u76ae\u80a4\u7684\u6210\u719fT\u7ec6\u80de\u6dcb\u5df4\u7624\u3002\u5149\u955c\u4e0b\u53ef\u89c1\u771f\u76ae\u6d45\u5c42\u53ca\u8840\u7ba1\u5468\u56f4\u6709\u591a\u6570\u7624\u7ec6\u80de\u548c\u591a\u79cd\u7c7b\u578b\u708e\u7ec6\u80de\u6d78\u6da6\u3002\u75c5\u53d8\u5c40\u9650\u4e8e\u76ae\u80a4\u8005\u9884\u540e\u8f83\u597d\uff0c\u6269\u6563\u81f3\u8840\u6db2\u548c\u5185\u810f\u9884\u540e\u8f83\u5dee\u3002<\/li>\n<li>Sezary\u7efc\u5408\u5f81\uff1a\u4e3aMF\u7684\u53d8\u5f02\u578b\uff0c\u4ee5\u51fa\u73b0\u7ea2\u76ae\u75c5(erythroderma)\u3001\u6dcb\u5df4\u7ed3\u80bf\u5927(lymphadenopathy)\u3001\u5916\u5468\u8840\u80bf\u7624\u6027T\u7ec6\u80de\u4e3a\u7279\u5f81\u3002\u4fb5\u88ad\u6027\uff0c\u7ec8\u672b\u671f\u53ef\u80fd\u6d89\u53ca\u6240\u6709\u5185\u810f\u5668\u5b98\u3002<\/li>\n<li>\u7ed3\u5916NK\/T\u7ec6\u80de\u6dcb\u5df4\u7624(extranodal NK\/T-cell lymphoma)\uff1a\u591a\u539f\u53d1\u4e8e\u9f3b\u8154\u3002\u5728\u4e1c\u4e9a\u4eba\u7fa4\u4e2d\u4e0eEBV\u611f\u67d3\u5bc6\u5207\u76f8\u5173\u3002\u5177\u6709\u4ee5\u8840\u7ba1\u4e3a\u4e2d\u5fc3(angiocentric)\u7684\u591a\u5f62\u6027\u6dcb\u5df4\u7ec6\u80de\u6d78\u6da6\uff0c\u7624\u7ec6\u80de\u6d78\u6da6\u7834\u574f\u8840\u7ba1(angiodestructive)\u7ee7\u800c\u5f15\u8d77\u574f\u6b7b\u7b49\u7279\u70b9\u3002\u53ef\u80fd\u5f88\u5feb\u4fb5\u72af\u5176\u4ed6\u90e8\u4f4d\u3002\u9884\u540e\u5dee\u3002<\/li>\n<li>\u95f4\u53d8\u6027\u5927\u7ec6\u80de\u6dcb\u5df4\u7624(anaplastic large cell lymphoma)\uff1a\u5e38\u8868\u73b0\u4e3a\u5916\u5468\u548c\u8179\u90e8\u6dcb\u5df4\u7ed3\u7684\u80bf\u5927\uff0c\u5e38\u6709\u7ed3\u5916\u7d2f\u53ca\u3002\u5e38\u89c1t(2;5)(p23;q35)\u5f62\u6210\u878d\u5408\u57fa\u56e0NPM-ALK\u3002CD30\u9633\u6027\u3002\u8be5\u75c5\u5728\u4fb5\u88ad\u6027\u6dcb\u5df4\u7624\u4e2d\u6709\u6700\u597d\u7684\u751f\u5b58\u7387\u3002<\/li>\n<\/ul>\n<h3 data-tool='mdnice\u7f16\u8f91\u5668'>3.4 \u970d\u5947\u91d1\u6dcb\u5df4\u7624(Hodgkin lymphoma, HL)<\/h3>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>3.4.1 \u7ecf\u5178\u578b\u970d\u5947\u91d1\u6dcb\u5df4\u7624(CHL)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u9996\u53d1\u75c7\u72b6\u662f\u5c40\u90e8\u6dcb\u5df4\u7ed3\u7684\u65e0\u75db\u6027\u3001\u8fdb\u884c\u6027\u80bf\u5927\u3002<\/li>\n<li>\u75c5\u53d8\u5f80\u5f80\u4ece\u4e00\u4e2a\u6216\u4e00\u7ec4\u6dcb\u5df4\u7ed3\u5f00\u59cb\uff0c\u9010\u6e10\u7531\u8fd1\u53ca\u8fdc\u7684\u5411\u5468\u56f4\u6dcb\u5df4\u7ed3\u6269\u6563\u3002\u53ef\u6269\u6563\u81f3\u813e\u810f\u3001\u809d\u810f\uff0c\u6700\u540e\u662f\u9aa8\u9ad3\u7d2f\u53ca\u548c\u6dcb\u5df4\u7ed3\u5916\u75c5\u53d8\u3002<\/li>\n<li>\u955c\u4e0b\u89c1\u591a\u79cd\u708e\u7ec6\u80de\u6df7\u5408\u6d78\u6da6\u4e3a\u80cc\u666f\uff0c\u6570\u91cf\u4e0d\u7b49\u3001\u5f62\u6001\u4e0d\u4e00\u7684\u80bf\u7624\u7ec6\u80de\u6563\u5e03\u5176\u95f4\u3002\u80bf\u7624\u7ec6\u80de\u5305\u62ecR-S\u7ec6\u80de\u53ca\u5176\u53d8\u5f02\u578b\u7ec6\u80de\u3002<\/li>\n<ul>\n<li>\u5178\u578b\u7684R-S\u7ec6\u80de\u662f\u4e00\u79cd\u76f4\u5f8415~45\u03bcm\u7684\u7624\u5de8\u7ec6\u80de\uff0c\u80de\u8d28\u4e30\u5bcc\uff0c\u6838\u5706\u5f62\u6216\u692d\u5706\u5f62\uff0c\u53cc\u6838\u6216\u591a\u6838\uff0c\u6838\u819c\u539a\uff0c\u6838\u5185\u6709\u4e00\u5927\u800c\u9192\u76ee\u7684\u55dc\u9178\u6027\u6838\u4ec1\uff0c\u6838\u4ec1\u5468\u56f4\u6709\u7a7a\u6655\u3002\u53cc\u6838R-S\u7ec6\u80de\u7684\u4e24\u4e2a\u6838\u5448\u9762\u5bf9\u9762\u6392\u5217\uff0c\u5f7c\u6b64\u5bf9\u79f0\uff0c\u79f0\u4e3a\u955c\u5f71\u7ec6\u80de(mirror image cell)\u3002<\/li>\n<li>\u76ee\u524d\u8bc1\u636e\u652f\u6301R-S\u7ec6\u80de\u8d77\u6e90\u4e8e\u6ee4\u6ce1\u751f\u53d1\u4e2d\u5fc3B\u7ec6\u80de\u3002<\/li>\n<\/ul>\n<\/ul>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>CD30 \uff0c\u5927\u591a\u6570CD15 \u3001CD20-\u3002<\/li>\n<li>\u6839\u636e\u75c5\u53d8\u7ec4\u7ec7\u4e2d\u80cc\u666f\u7ec6\u80de\u6210\u5206\u4e0e\u80bf\u7624\u7ec6\u80de\u5f62\u6001\uff0c\u5206\u4e3a\u56db\u4e2a\u4e9a\u578b\uff1a<\/li>\n<ul>\n<li>\u7ed3\u8282\u786c\u5316\u578b(nodular sclerosis, NS)<\/li>\n<li>\u6df7\u5408\u7ec6\u80de\u578b(mixed cellularity, MC)<\/li>\n<li>\u5bcc\u4e8e\u6dcb\u5df4\u7ec6\u80de\u578b(lymphocyte-rich)<\/li>\n<li>\u6dcb\u5df4\u7ec6\u80de\u51cf\u5c11\u578b(lymphocyte depletion, LD)\uff0c\u6700\u5c11\u89c1\uff0c\u9884\u540e\u6700\u5dee<\/li>\n<\/ul>\n<li>\u6839\u636e\u80bf\u7624\u7d2f\u53ca\u8303\u56f4\u8fdb\u884c\u4e34\u5e8a\u5206\u671f\uff0c\u5bf9\u4f30\u8ba1\u9884\u540e\u548c\u6cbb\u7597\u65b9\u6848\u7684\u9009\u62e9\u5177\u6709\u6307\u5bfc\u610f\u4e49\u3002\u653e\u7597\u548c\u5316\u7597\u8fdb\u6b65\u4f7fHL\u6210\u4e3a\u4e34\u5e8a\u53ef\u6cbb\u6108\u7684\u75be\u75c5\u3002<\/li>\n<\/ul>\n<h4 data-tool='mdnice\u7f16\u8f91\u5668'>3.4.2 \u7ed3\u8282\u6027\u6dcb\u5df4\u7ec6\u80de\u4e3a\u4e3b\u578b\u970d\u5947\u91d1\u6dcb\u5df4\u7624(nodular lymphocyte-predominant HL, NLPHL)<\/h4>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>\u4e0d\u5e38\u89c1\uff0c\u7ea6\u5360\u6240\u6709HL\u76845%\u3002<\/li>\n<li>\u591a\u53d1\u4e8e\u7537\u6027\uff0c30~50\u5c81\u3002<\/li>\n<li>\u4e3b\u8981\u8868\u73b0\u662f\u9888\u90e8(cervical)\u3001\u814b\u4e0b(axillary)\u3001\u8179\u80a1\u6c9f(inguinal)\u7b49\u6dcb\u5df4\u7ed3\u80bf\u5927\u3002<\/li>\n<li>\u75c5\u53d8\u6dcb\u5df4\u7ed3\u5448\u6df1\u67d3\u7684\u6a21\u7cca\u4e0d\u6e05\u7684\u5927\u7ed3\u8282\u72b6\u6784\u8c61\uff0c\u5178\u578bR-S\u7ec6\u80de\u96be\u89c5\uff0c\u80bf\u7624\u7ec6\u80de\u662f\u591a\u5206\u53f6\u6838\u7684\u7206\u7c73\u82b1\u7ec6\u80de\uff08LP\u7ec6\u80de\uff09\u3002<\/li>\n<li>\u7624\u7ec6\u80de\u8868\u8fbeB\u7ec6\u80de\u6807\u8bb0\uff0cCD20\u548cCD79a\u9633\u6027\uff0c\u4e0d\u8868\u8fbeCD15\u3002<\/li>\n<li>\u9884\u540e\u8f83\u597d\u3002<\/li>\n<\/ul>\n<h2 data-tool='mdnice\u7f16\u8f91\u5668'>4 Langerhans\u7ec6\u80de\u7ec4\u7ec7\u7ec6\u80de\u589e\u751f\u75c7(Langerhans cell histiocytosis)<\/h2>\n<ul data-tool='mdnice\u7f16\u8f91\u5668'>\n<li>Langerhans\u7ec6\u80de\u662f\u4e00\u79cd\u4e0d\u6210\u719f\u7684\u6811\u7a81\u72b6\u7ec6\u80de\u3002\u7ec6\u80de\u8868\u9762\u6709\u5c0f\u7a81\u8d77\uff0c\u80de\u8d28\u4e30\u5bcc\uff0c\u6838\u5f62\u72b6\u4e0d\u89c4\u5219\uff0c\u5e38\u6709\u6838\u6c9f\u6216\u5448\u5206\u53f6\u72b6\u3002<\/li>\n<li>\u5176\u514b\u9686\u6027\u589e\u751f\u6709\u4e09\u79cd\u8868\u73b0\u5f62\u5f0f\uff1a<\/li>\n<ul>\n<li>Letterer-Siwe\u75c5\uff1a\u591a\u7cfb\u7edf\u3001\u591a\u75c5\u7076(multifocal, multisystem)\uff0c\u591a\u89c1\u4e8e\u4e24\u5c81\u4ee5\u4e0b\u7684\u5a74\u5e7c\u513f\u3002\u53d1\u75c5\u6025\u3001\u8fdb\u5c55\u5feb\u3001\u75c5\u7a0b\u77ed\u3002\u53d1\u70ed\u3001\u76ae\u75b9(rash)\uff0c\u809d\u3001\u813e\u3001\u6dcb\u5df4\u7ed3\u80bf\u5927\uff0c\u6eb6\u9aa8\u6027\u9aa8\u8d28\u7834\u574f\uff0c\u5168\u8840\u7ec6\u80de\u51cf\u5c11\u3002\u589e\u751f\u7684Langerhans\u7ec6\u80de\u5448\u5375\u5706\u5f62\uff0c\u6838\u5448\u4e2d\u7b49\u4e30\u5bcc\uff0c\u6838\u5448\u6298\u53e0\u72b6\u3001\u51f9\u9677\u6216\u5206\u53f6\u72b6\uff0c\u5e38\u6709\u6838\u6c9f\uff0c\u4f3c\u5de8\u566c\u7ec6\u80de\u3002<\/li>\n<li>Hand-Schuller-Christian\u75c5\uff1a\u5355\u7cfb\u7edf\u3001\u591a\u75c5\u7076(multifocal, unisystem)\uff0c\u591a\u4e2a\u6216\u8fde\u7eed\u53d1\u751f\u7684\u6eb6\u9aa8\u6027\u3001\u7834\u574f\u6027\u9aa8\u75c5\u53d8\u3002<\/li>\n<li>\u9aa8\u55dc\u9178\u6027\u8089\u82bd\u80bf(isolated eosinophilic granuloma of the bone)\uff1a\u5355\u4e00\u75c5\u7076\uff0c\u5c40\u9650\u4e8e\u9aa8\u9abc\uff0c\u4ee5\u81a8\u80c0\u6027\u3001\u4fb5\u8680\u6027\u9aa8\u75c5\u53d8\u4e3a\u7279\u5f81\u3002\u4e34\u5e8a\u75c5\u7a0b\u4e0e\u8bca\u65ad\u65f6\u7d2f\u53ca\u7684\u5668\u5b98\u6570\u91cf\u6709\u5173\u3002<\/li>\n<\/ul>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>1 \u53cd\u5e94\u6027\u6dcb\u5df4\u7ed3\u708e 1.1 &nbsp;\u6025\u6027\u975e\u7279\u5f02\u6027\u6dcb\u5df4\u7ed3\u708e(acute non &hellip; <a href=\"http:\/\/zydq.1006ss.com\/?p=48152\">\u7ee7\u7eed\u9605\u8bfb <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[70],"tags":[],"class_list":["post-48152","post","type-post","status-publish","format-standard","hentry","category-70"],"_links":{"self":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/48152","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=48152"}],"version-history":[{"count":0,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=\/wp\/v2\/posts\/48152\/revisions"}],"wp:attachment":[{"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=48152"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=48152"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/zydq.1006ss.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=48152"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}