血液癌是一群多样的疾病，当恶性血细胞发生肿瘤性增殖时发生haemopoietic system. The clinical presentation of blood cancers is variable and highly dependent on the site and severity of the disease.

Blood cancer classification

Blood cancers are classified into myeloid (related to bone marrow) or lymphoid (related to tissue that produces lymphocytes and antibodies) disorders based on the haemopoietic lineage in which an abnormality occurred; they can also further be categorised into one of the following groups:

Leukaemia是一种癌症，在骨髓和外周血中发现了恶性造血细胞。白血病可以根据疾病的发作率分类为髓样或淋巴样，并急性或慢性病。在急性白血病中，爆炸异常（分化的未成熟细胞）异常，并且可能发生成熟停滞。相反，由于恶性细胞在造血期间继续成熟，因此慢性白血病与爆炸无关。白血病有四个主要类别：AML（急性髓性白血病），所有（急性淋巴白血病），CML（慢性髓细胞性白血病）和CLL（慢性淋巴白血病）。

Lymphomas影响淋巴谱系，是慢性恶性肿瘤。恶性淋巴样细胞通常积聚并仅限于引起淋巴瘤静态肿瘤的淋巴机构。如果受影响的淋巴器官变得如此不知所措并与恶性细胞积聚，则细胞会迫使浸润进入淋巴组织外部的器官，例如外周血和骨髓。淋巴瘤广泛分为霍奇金淋巴瘤（HL）和非霍奇金淋巴瘤（NHL），基于恶性肿瘤是否含有REED-STRENBERG细胞（仅与HL相关的异常淋巴细胞）。

Myelodysplastic syndromesare myeloid malignancies in which immature precursor myeloid cells accumulate in the bone marrow. As a consequence, the death of these immature cells occurs before they can mature into effector cells. This causes ineffective haemopoiesis and consequently a reduction in the red cells, white cells and platelets.

Multiple myelomais a lymphoid malignancy in which there is abnormal proliferation of malignant plasma cells. In health, plasma cells are required for antibody production; in multiple myeloma, malignant plasma cells over-synthesise and secrete excessive quantities of monoclonal immunoglobulins called paraproteins. In excess concentrations in the plasma, paraproteins can cause severe tissue damage to a number of organs.

Myeloproliferative disordersare myeloid abnormalities in which there is abnormal overproduction of myeloid cells in the bone marrow, most commonly causing erythrocytosis, thrombocytosis, neutrophilia and basophilia. The main myeloproliferative disorders are CML, polycythaemia vera, myelofibrosis and essential thrombocythaemia.

Investigation of blood cancers

病理实验室的作用对于研究血癌至关重要。重要的是要准确诊断恶性肿瘤，因为治疗策略差异很大，无法正确诊断患者可能会对他们的预后产生重大影响。可以在研究可疑的血液癌的研究中使用许多不同的测试和分析技术，包括以下内容：

Afull blood count（FBC）提供有关红细胞，白细胞和血小板指数的数据。这些参数是必不可少的，因为它们详细介绍了每个细胞系的数量并有助于确定骨髓受累。在某些情况下，FBC结果是可疑血液癌的第一个迹象之一，可能是FBC分析的结果，要求进一步研究。

Morphological examination外周血和/或骨髓有助于确定血细胞的形状，大小，特征，细胞包含和成熟度。特定的形态特征与某些类型的血液癌明显相关，因此形态的分析在帮助诊断或表明进一步研究的情况下是关键的。

免疫表型analyzes the expression of antigenic markers expressed on cellular surfaces; these markers are called clusters of differentiation (CD) markers. Specific markers associated with each cell lineage allow cellular populations to be identified. In health, certain CD markers should be present, however in malignancy there can be the loss of expression, over-expression and the aberrant expression of specific markers which should not be present in a healthy individual. By comparing results to the normal expected expression, differentiation can be made between healthy cell and malignant cell populations.

细胞遗传学studies cells at the molecular level since some blood cancers are caused by a chromosomal mutation. By analyzing a patient’s karotype and chromosomal structure, genetic mutations can be identified.

组织学检查of a biopsy (for example a lymph node), can reveal tissue architecture including the type of cells present. This helps to determine the presence and/or spread of a malignancy.

Due to the heterogeneous nature of blood cancers, a multidisciplinary laboratory approach is often necessary for diagnosis. Hence, to aid a diagnosis, all laboratory results must be interpreted in conjunction to the clinical presentation.

Innovations and advancements are rapidly progressing in the field of blood cancers with the aim of ultimately helping to reduce the prevalence of such diseases and improve the prognosis for the individuals affected.

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