细胞形态学观察在骨髓增生异常综合征诊断中价值

Cell morphology in the diagnosis of myelodysplastic syndromes value

目的探讨骨髓增生异常综合征(MDS)细胞形态学病态造血特点,以寻求诊断MDS的价值。方法以WHO MDS分类标准为诊断金标准,收集2007年3月1日至2012年3月6日期间,诊断的MDS患者165例。非克隆性疾病患者165例作为对照组。分析骨髓与血片细胞学检查中病态造血特征在克隆性和非克隆性疾病中的诊断价值。结果 MDS病态造血形态学诊断的主要依据:粒系Auer小体、核出芽、微核;红系核出芽;外周血片中出现巨核细胞、原粒细胞或早幼红细胞。结论细胞形态学是诊断MDS的基础,但也存在一定的局限性,尤其早期MDS细胞形态学改变不典型时,恶性克隆处于非显性状态,表达特征亦不明显,需要结合其他检测手段,以便早期诊断和治疗。

Objective Studying myelodysplastic syndrome（MDS） cell morphology morbid hematopoietic characteristics,in order to seek the value of diagnosing MDS.Methods According to WHO MDS criteria for classification as the gold standard for diagnosis,from 1st March 2007 to 6th Marth 2012,the diagnosis of 165 cases with MDS were collected.Non clonal disease165 cases were treated as the control group.Analysis of bone marrow and blood cytology in morbid hematopoietic characteristics in clonal and non-clonal diagnostic value.Results MDS morbid hematopoietic morphological diagnosis of main basis： myeloid Auer bodies,nuclear budding,micronucleus,erythroid nuclear budding,peripheral blood piece in appear megakaryocytes,raw or granulocyte basophilic erythroblast.Conclusion Cytomorphological diagnosis of MDS foundation.But there also exist some limitations,especially in early MDS cell morphological change is not typical,the malignant clone in dominant status,expression feature is not apparent,need to be combined with other detection means,so that early diagnosis and treatment.