65例骨髓组织病理定量分析

A quantitative pathological analysis on 65 bone marrow tissue sections

目的：研究骨髓组织病理学定量分析在血液病中的作用。方法：对５９例血液病患者及６例正常人骨髓组织切片进行了造血组织、脂肪组织及骨小梁等病理学定量分析；Ｍａｓｓｏｎ三色染色和Ｇｏｍｏｒｉ网状纤维染色观察。结果：与其他血液病及正常人骨髓相比，再生障碍性贫血（再障）病人骨髓的造血组织数及造血面积明显减少（Ｐ＜０．０５），脂肪组织数及脂肪组织面积明显增多（Ｐ＜０．０５），骨小梁数及骨小梁面积明显减少（Ｐ＜０．０１）。Ｍａｓｏｎ胶原纤维在血液病中均有不同程度的阳性，其中急白组和ＭＤＳ组高于其他组。ＡＬ组中度阳性及强阳性为２８％，而ＭＤＳ组为６７％，ＣＡＡ组为１３％；Ｇｏ－ｍｏｒｉ网银蛋白染色在急白组无中度阳性和强阳性，在ＭＤＳ组中为７８％，而再障组无中度阳性和强阳性。结论：骨髓组织病理学定量分析对血液病具有鉴别诊断意义。

Purpose To study the significance of quantitative pathological analysis on bone marrow tissue of hematological diseases. Methods Fifty nine bone marrow tissue sections from different hematological patients and six from normal persons were analyzed on hemopoietic tissue, adipose tissue, bone trabecula by quantitative methods, massons trichrome stain and Gomoris silver stain. Results In aplastic anemia group the number and area of hemopoietic tissue and bone trabecula were signficantly decreased ( P<0 05,P<0 01 respectively), while the number and area of adipose tissue were significantly increased ( P <0 05) compared with bone marrow tissues from normal and other diseases. Massons collagenous fibers were positive in hematological disease groups, and its moderate and strong positive fibers were higher in acute leukemia (28%) and MDS (67%) groups than those in chronic aplastic anemia group (13%). In MDS group, 78% cases with moderate and strong positive Gomoris stain were found, while there was no positive staining in acute leukemia and aplastic anemia groups. Conclusions Quantitative pathological analysis on bone marrow tissue has a differential diagnostic significance in hematological diseases.