白血病淋巴瘤傻傻分不清楚，医生说的都是什么天书？
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">一说到去医院看<span style="color: black;">大夫</span>，估计不少人都觉得头大。害怕真的<span style="color: black;">检测</span>出什么毛病是一回事，被<span style="color: black;">大夫</span>的专业知识“碾压智商”又是另一种可怕。<span style="color: black;">大众</span>总开玩笑，<span style="color: black;">医生</span>们个个都是狂草专家，嗨，<span style="color: black;">不但</span>病历写得像天书，<span style="color: black;">医生</span>说的<span style="color: black;">哪些</span>个专业名词<span style="color: black;">亦</span>是统统听不懂啊，最后连自己到底得的啥病都没弄明白，你说闹不闹心！</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">在<span style="color: black;">许多</span><span style="color: black;">疾患</span>里，血液肿瘤又尤为<span style="color: black;">繁杂</span>，什么白血病、淋巴瘤、骨髓瘤，病名能有十个字<span style="color: black;">那样</span>长，<span style="color: black;">况且</span>这些<span style="color: black;">疾患</span>明明大类别都不<span style="color: black;">同样</span>，有时却会被归类到<span style="color: black;">一块</span>，<span style="color: black;">例如</span>说慢性淋巴细胞白血病（CLL）和小淋巴细胞淋巴瘤（SLL），临床上居然认为是一种<span style="color: black;">疾患</span>。一个白血病，一个淋巴瘤，咋就<span style="color: black;">成为了</span>一种病呢？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">别说<span style="color: black;">病人</span>听不懂，医学生都是一头雾水啊，难怪要在网上提这种专业问题。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">其实，<span style="color: black;">导致</span>这种混乱的<span style="color: black;">原由</span>是，以前惯用的<span style="color: black;">归类</span><span style="color: black;">办法</span>是把白血病和淋巴瘤<span style="color: black;">掰开</span>来当作两大类<span style="color: black;">疾患</span>看待的。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">例如</span>说，<span style="color: black;">此刻</span>的白血病<span style="color: black;">归类</span>是<span style="color: black;">根据</span>癌变细胞的成熟状态分成急性和慢性，FAB<span style="color: black;">归类</span>又把急性白血病分成淋巴细胞和非淋巴细胞两组，哎，怎么还有淋巴细胞的事儿，那淋巴瘤又是怎么分的啊？</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">看到<span style="color: black;">这儿</span>是不是<span style="color: black;">已然</span>懵了？<span style="color: black;">咱们</span>上一期<span style="color: black;">说到</span>过，血液肿瘤的癌细胞本是同根生，都在血细胞<span style="color: black;">大众</span>族里，<span style="color: black;">亦</span><span style="color: black;">便是</span>说虽然长得千奇百怪，可<span style="color: black;">实质</span>上是一家人呐，<span style="color: black;">同期</span><span style="color: black;">根据</span>两套标准去规定，不乱就怪了。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">其实比起FAB<span style="color: black;">归类</span>和REAL<span style="color: black;">归类</span>，WHO提出的血液肿瘤<span style="color: black;">归类</span>才更加清晰明了，<span style="color: black;">由于</span>它的<span style="color: black;">归类</span>标准，<span style="color: black;">便是</span><span style="color: black;">根据</span>细胞起源。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">说这些病到底怎么回事之前，先来简单复习一下血细胞<span style="color: black;">大众</span>族：造血细胞<span style="color: black;">能够</span>分化成髓系细胞和淋系细胞，髓系细胞负责循环系统的“基层工作”，<span style="color: black;">包含</span>快递员红细胞、民警粒细胞、修理工巨核细胞、清洁工单核细胞；淋系细胞负责身体的“反恐工作”，<span style="color: black;">包含</span>突击手T细胞和NK细胞，狙击手B细胞。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">血细胞<span style="color: black;">大众</span>族<span style="color: black;">整家</span>福</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">好了，记住这些角色，<span style="color: black;">此刻</span>咱们就来扒一扒白血病和淋巴瘤到底是怎么回事了。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">首要</span>，白血病和淋巴瘤的区别是啥？它俩的名字来自<span style="color: black;">疾患</span>的症状，<span style="color: black;">倘若</span>有“肿块”形成，<span style="color: black;">例如</span>淋巴结肿大，就叫它淋巴瘤；而<span style="color: black;">倘若</span>血液或骨髓中癌细胞数量超过<span style="color: black;">必定</span>的比例，就<span style="color: black;">能够</span>叫白血病。<span style="color: black;">因此</span>有的时候，当淋巴瘤发展到晚期，癌细胞进入骨髓或外周血，它<span style="color: black;">亦</span>会摇身一变从淋巴瘤改名成白血病。<span style="color: black;">这般</span>就很好理解了吧。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">其次，<span style="color: black;">所说</span>急性和慢性，是取决于癌变细胞的生长速度的。从造血干细胞<span style="color: black;">起始</span>，细胞分化级别越高、特征越成熟、增殖<span style="color: black;">潜能</span>越弱，<span style="color: black;">那样</span><span style="color: black;">倘若</span>它癌变了，它<span style="color: black;">做为</span>恶棍的特征就越<span style="color: black;">知道</span>、扩增的速度<span style="color: black;">亦</span>就更慢，<span style="color: black;">亦</span><span style="color: black;">便是</span><span style="color: black;">所说</span>的“慢性”；相对的，<span style="color: black;">倘若</span>是在造血祖细胞和干细胞<span style="color: black;">周期</span>就癌变，<span style="color: black;">那样</span><span style="color: black;">导致</span>的影响就广、<span style="color: black;">疾患</span>发展的速度<span style="color: black;">亦</span>就越快，即“急性”。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">髓系肿瘤比较简单，<span style="color: black;">按照</span>WHO的指南<span style="color: black;">能够</span>分为四类。<span style="color: black;">第1</span>类是急性髓系白血病（AML），它的特征是骨髓中<span style="color: black;">反常</span>白血病细胞超过20%，<span style="color: black;">按照</span><span style="color: black;">详细</span><span style="color: black;">患病</span>的是红细胞、白细胞、粒细胞还是单核细胞，又<span style="color: black;">能够</span>分为8类，<span style="color: black;">亦</span><span style="color: black;">便是</span>M0-M7。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">显微镜下的AML细胞</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">第二类是骨髓增生<span style="color: black;">反常</span><span style="color: black;">综合症</span>（MDS），它和AML的差别就在于，<span style="color: black;">反常</span>白血病细胞的数量小于20%。第三类叫做骨髓增殖性<span style="color: black;">疾患</span>（MPD），它的特点是骨髓中某一个系列的细胞<span style="color: black;">海量</span>增殖，前段时间<span style="color: black;">由于</span>《我不是药神》而为人熟知的慢性粒细胞白血病，<span style="color: black;">便是</span>MPD的一员。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">善于思考的病友可能<span style="color: black;">已然</span><span style="color: black;">发掘</span>了，MDS和MPD并不矛盾啊，两个<span style="color: black;">前提</span>都符合的时候又要怎么分呢？<span style="color: black;">因此</span>第四类MDS/MPD，就<span style="color: black;">包含</span>了这些<span style="color: black;">不可</span>够被明确<span style="color: black;">归类</span>的髓系肿瘤。</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">淋系肿瘤就要<span style="color: black;">繁杂</span><span style="color: black;">有些</span>，<span style="color: black;">由于</span><span style="color: black;">触及</span>到白血病和淋巴瘤的交叉部分了。<span style="color: black;">然则</span><span style="color: black;">咱们</span><span style="color: black;">不消</span>太<span style="color: black;">留意</span><span style="color: black;">疾患</span>的名<span style="color: black;">叫作</span>，只要记住两个<span style="color: black;">方向</span>，一是细胞的类型，<span style="color: black;">亦</span><span style="color: black;">便是</span>B、T、NK，而是细胞的分化成熟状态，<span style="color: black;">亦</span><span style="color: black;">便是</span>急性慢性，除此之外<span style="color: black;">便是</span><span style="color: black;">拥有</span>独特细胞形态的霍奇金淋巴瘤。</p>
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<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">霍奇金淋巴瘤有对“小眼睛”</p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;">怎么样，<span style="color: black;">此刻</span>是不是觉得清晰了<span style="color: black;">非常多</span>？其实随着科技手段的<span style="color: black;">持续</span>进步，<span style="color: black;">咱们</span>对<span style="color: black;">疾患</span>的<span style="color: black;">认识</span><span style="color: black;">亦</span>越来越深入细致。以前只能够靠显微镜下细胞和组织的形态来<span style="color: black;">归类</span>，<span style="color: black;">此刻</span><span style="color: black;">咱们</span><span style="color: black;">已然</span><span style="color: black;">能够</span>从分子水平的差异给<span style="color: black;">疾患</span>们盖章啦。</p>
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