以骨髓转移癌为首发表现的骨髓外肿瘤57例分析

Analysis on 57 Extracellular Bbone Marrow Tumors Which Bone Metastasis as First Symptom

目的:了解以骨髓转移首发的骨髓转移癌患者的临床特征及实验室检查特点,提高对该疾病的认识。方法:对57例骨髓转移癌患者的临床特征及实验室检查结果进行回顾分析。结果:临床上以贫血最为常见,其次为骨痛及发热;常见的血象异常包括贫血、血小板减少、外周血涂片出现幼红、幼粒细胞,血沉增高,碱性磷酸酶、乳酸脱氢酶升高,肿瘤标志物增高及凝血功能障碍;骨髓细胞学检查均找到数量不等的癌细胞团和(或)单个散落的癌细胞,多见于片尾及边缘。结论:骨髓转移癌患者临床以不明原因的贫血、骨痛、发热等症状且伴有外周血涂片出现幼红、幼粒细胞,血沉增高,碱性磷酸酶、乳酸脱氢酶升高,肿瘤标志物增高等为主要特点;发现有此现象的患者,应考虑到骨髓转移癌可能,及早行骨髓学检查,避免漏诊与误诊。而凝血功能异常,临床应引起重视,以免骨髓出现坏死。

Objective： To understand the clinical feature and laboratory examination of metastases cancer of bone marrow（MCBM）which bone metastasis as first symptom and to enhance the cognition of MCBM.Methods： Retrospective analysis of 57 cases of MCBM.Results： In MCBM patients, the most common clinical symptom is anemia, then bone pain and fever; the abnormal hemogram include anemia, thrombocytopenia; immature erythrocytes and granulocyte were seen on the peripheral blood smear; ESR, AKP, LDH and tumor markers increased and with coagulation disorders; all of patients were found cancer cells in heaps or single cancer cell in marrow cytological examination.Conclusion： The clinical symptom of MCBM patients is commonly include anemia, bone pain, fever, immature erythrocytes and granuloeyte were seen on the peripheral blood smear, ESR, AKP, LDH and tumor markers increased. When we found patients with above mentioned symptom, we should consider there may be MCBM and do marrow cytological examination earlier.It＇ s necessary to pay much attention to coagulation disorders in MCBM patients to avoid bone marrow necrosis.