骨髓活检在恶性血液病诊断中的意义

Significance of Marrow Histotomy in Diagnosing Malignant Hemology

目的应用骨髓活检和涂片相结合,对82例恶性血液病患者的骨髓进行骨髓切片和涂片结果的分析,以期进一步提高形态学诊断及预后判断。方法收集恶性血液病病例82例,一步法抽吸骨髓,常规方法涂片染色,塑料包埋法制作组织切片;恶性血液病的诊断参照2001年WHO分型标准。结果骨髓活检和涂片相结合,在诊断骨髓纤维化、低增生性骨髓增生异常综合征,骨髓活检诊断符合率高于骨髓涂片。对于淋巴瘤骨髓受累的病例,骨髓活检更容易找到特征性的淋巴瘤细胞;对多发性骨髓瘤,活检切片是体内肿瘤负荷更敏感的指标;对慢性粒细胞性白血病判断急变及急性白血病判断缓解后复发,骨髓活检常能进行较好的监测。结论骨髓活检和穿刺涂片相结合,可以有效提高恶性血液病的诊断水平。

Objective To promote the level of morphological diagnosis and estimate prognosis combining the result of bone marrow histotomy and the swear of 82 cases of malignant hemology disease. Methods We collected 82 cases of malignant hemology disease, extracted marrow by one step and routinly made bone marrow swear and dyeing, made histotomy by embedding plastic. Diagnosis of malignant he- mology disease refered to the standard of WHO 2001. Results Bone marrow histotomy was superior to bone marrow swear in diagnosing MF and hypocellular MDS. Bone marrow histotomy was easier to find cell of lymphoma than bone marrow swear. Bone marrow histotomy was a more sensitive index of tumor load of MM. It was also helpful for judging acute change of CML and relapse of acute leukemia. Conclusion Level of diagnosing malignant hemology disease can be promoted efficiently by combining marrow histotomy with bone marrow swear.