多发性骨髓瘤骨髓切片的意义及与涂片比较

SIGNIFICANCE AND COMPARISON WITH SMEARS OF SECTIONS OF BONE MARROW BIOPSY AT PATIENTS WITH MULTIPLE MYELOMA

目的 :了解多发性骨髓瘤 (MM)骨髓活检切片的变化 ,评价骨髓切片在MM中的意义。方法 :运用塑料包埋切片技术观察了 43例MM患者的骨髓切片 ,并与涂片进行比较。结果 :MM骨髓切片中浆细胞以结节状及大片状浸润为主 ,这种浸润方式对MM诊断的敏感性达 88.4% ,明显高于涂片中浆细胞 >15 %作为指标的敏感性 (6 5 .1% ) ;浸润方式能较客观地反映患者的肿瘤量分级与临床分期 ;切片中骨髓增生程度也显著高于涂片。结论 :与涂片比较 ,MM的骨髓切片有一定优越性 ,对MM的诊断、化疗方案的选择及预后估计具有重要意义。

Objective:To understand the regularity and the significance of bone marrow (BM) sections samples in the patients with multiple myeloma(MM).Methods:The embedden sections in plastic of biopsy and the smears of 43 patients with MM were observed and compared.Results:The infiltration pattern of plasma cells in BM sections was mainly regarded as nodular and packed.The sensitivity of the infiltration patterns to diagnosis of MM was 88.4% and higher than that of the smears (65.1%) The infiltration pattern of plasma cells in sections could objectively reflect tumour burden and clinical stage of patients with MM.The degree of cellularity in sections was higher than in smears.Conclusions:The BM sections of MM is superior to the smears in some degree and is valuable in diagnosis,selection of chemotherapy regimen and prognosis.