骨髓涂片联合骨髓活检对诊断骨髓增生异常综合征的意义

The study on the union between marrow smear and marrow biopsy in the myelodysplastic syndrome diagnosis

目的探讨骨髓穿刺涂片与骨髓活检切片同步观察对诊断骨髓增生异常综合症(MDS)的临床意义。方法针对86例MDS患者采用骨髓抽吸—活检双标本一步法取材,同步观察其涂片和切片。结果86例MDS患者骨髓穿刺涂片增生程度极度减低～减低30例(34.88%),活跃、明显活跃、极度活跃56例(65.12%),红系病态造血43例(50.00%),粒系病态造血32例(37.21%),巨核系病态造血22例(25.58%)。骨髓活检切片的增生程度极度减低～减低15例(17.44%),活跃、明显活跃、极度活跃71例(82.56%),红系病态造血16例(18.61%),粒系病态造血52例(60.47%),巨核系病态造血56例(65.12%)。结论骨髓涂片和活检在MDS的诊断和分型中各有优点,两者相互补充,二者同步观察比常规穿刺涂片形态学观察更有利于提高MDS诊断的准确性。

Objective To explore the clinical significance of the union between marrow smear and marrow biopsy in the myelodysplastic syndrome diagnosis. Methods Aspirate bone marrow and smear, then encircled drill bone tissues and make section at the same point which is called as easy one-step technology to 86 MDS patients. Results In 86 cases of MDS patients, there were 30 cases of hyperplasia extreme degree of reduction and the reduction （34.88%）, 56 cases of active, obvious and extremely active active （65.12%）, 43 cases for red RCMD （50.00%）, 32 cases for the granulocyte dysplasia （37.21%）, 22 cases for megakaryocyte RCMD （25.58%） in bone marrow aspiration smears; compared with there were 15 cases of hyperplasia extreme degree of reduction and the reduction （17.44%）, 71 cases of active, obviously active and extremely active （82.56%）; 16 cases for red RCMD （18.61%）, 52 cases for the granulocyte dysplasia （60.47%）, 56 cases for megakaryocyte RCMD （65.12%） in bone marrow biopsy sections. Conclusion The biopsy slice and the puncture smear synchronization observation is more advantageous than the conventional puncture smear morphology observation in enhances the accuracy in the MDS diagnosis.