30例骨髓转移癌实验室检查及临床特点分析

Laboratory Inspection and Clinical Characteristics of 30 Cases of Bone Marrow Metastatic Cancer

目的探讨骨髓转移癌的临床表现及实验室检查特点,以提高对该病的诊断水平。方法对2008年1月-2015年1月在贵阳市某医院经骨髓活检组织病理学检查和骨髓涂片形态学检查确诊的30例骨髓转移癌患者的实验室检查资料及临床表现进行回顾性分析。结果患者临床表现以贫血最常见,其后依次为骨痛、发热、消瘦及纳差、出血;28例(93.3%)患者肿瘤标志物水平升高,20例(66.7%)患者乳酸脱氢酶(LDH)水平升高,21例(70.0%)患者碱性磷酸酶(ALP)水平升高,12例(40.0%)患者铁蛋白(SF)水平升高,21例(70.0%)患者血清白蛋白(ALB)水平下降;骨髓活体组织检查显示,骨髓增生明显活跃2例(6.7%),骨髓增生活跃26例(86.6%),骨髓增生减低2例(6.7%);骨髓涂片细胞学检查显示,涂片尾部及边缘可见数量不等的散在或成团、成簇分布的癌细胞。结论临床医生应提高对骨髓转移癌的认识,综合分析患者病史、体征及实验室检查结果,以提高骨髓转移癌的确诊率。

Objective This article explores laboratory inspection and clinical characteristics of bone marrow metastatic cancer in order to improve its diagnostic accuracy.Method 30 patients from January 2008 to January2015in one of Guiyang hospital were diagnosed with bone marrow metastatic cancer by bone marrow biopsy and bone marrow aspiration.This paper analyzed clinical characteristics of this disease based on results of laboratory inspection.Results The most common clinical characteristics was anemia,followed by bone pain,fever,emaciation,poor appetite and bleeding.28patients′（93.3%）level of tumor marker became higher,20patients′（66.7%）level of lactic dehydrogenase（LDH）increased,21patients′（70.0%）level of alkaline phosphatase（ALP）enhanced,12patients′（40.0%）level of serum ferritin（SF）climbed,21patients′（70.0%）level of albumin（ALB）decreased.The results of bone marrow biopsy showed that 2cases（6.7%）had evidently active myelosis,26cases（86.6%）were active and 2cases（6.7%）had fewer myelosis.The bone marrow aspiration presented that cancer cells distributed as individual or clustered on the tail and edge of smears.Conclusion Clinical doctors must increase the awareness of bone marrow metastatic cancer,comprehensively analyze patients′medical history,signs and results of laboratory examination so as to enhance the diagnostic accuracy.