恶性肿瘤骨髓转移的形态学检验与临床特点分析

Morphological examination and clinical characteristics analysis of transfer of bone marrow in malignant tumor

目的探讨恶性肿瘤骨髓转移的形态学检验与临床特点。方法选取济源市人民医院血液科2010年5月至2014年5月收治的恶性肿瘤骨髓转移患者40例，均行活组织和骨髓涂片检查，并分析其临床特点。结果40例恶性肿瘤骨髓转移患者均行骨髓涂片检查，阳性34例，占85％。骨髓活组织检查6例，阳性率为83．3％。涂片检查6例阴性中，3例骨髓增生低下，但其活组织增生极度活跃，纤维组织部分增生，表明穿刺针中有小凝血块或抽吸时可能稀释，对涂片质量有影响；另3例在进针时骨质过硬，出现干抽情况，有核细胞数量在涂片中极少，均由活组织检查对阴性的6例诊断，效果理想。活组织检查中，1例阴性因取材标本较小，对诊断有影响。结论恶性肿瘤临床以骨髓为常见转移部位，活组织和骨髓涂片同步双标本检测有较高阳性率，二者得出的结果有互补效果。

Objective To study the morphological examination and clinical characteristics analysis of transfer of bone marrow in malignant tumor. Methods From May 2010 to May 2014, fourty patients with transfer of bone marrow in malignant tumor were selected. Living tissue and bone marrow smears were detected, the clinical characteristics were analyzed. Results Fourty patients with malignant tumors were all taken the examination of smear of bone marrow. There were 34 cases, accounting for 85%. There were 6 cases of bone marrow biopsy, the positive rate was 83.3%. Among 6 cases of negative smears, 3 cases of bone marrow hyperplasia, but their living tissue hyperplasia was hyperactive, parts of fibrous tissue had hyperplasia. It showed that small sludged blood in puncture needle or may be diluted when pumping, which can influent the smear quality. Among other 3 cases, dry tap appeared because sclerotin was too hard when inserting needles, there was a few number of nucleated cells in the smears. Six negative cases were diagnosed by biopsy whose effects were ideal. Because one specimen was lesser, one case of negative specimen had effects on diagnosis. Conclusions Bone marrow is treated as common transfer parts of malignant tumor clinically. Synchronous double samples of biopsy and bone marrow smear have higher positive rates, and results have a complementary effect between them.