骨髓细胞形态学检查在非霍奇金淋巴瘤骨髓侵犯中的临床价值

Role of bone marrow morphological examination in the bone marrow infiltration of non-Hodgkin’s lymphoma

目的评估骨髓涂片细胞学检查在判断非霍奇金淋巴瘤(NHL)骨髓侵犯的准确性以及骨髓穿刺涂片和骨髓活检在检测NHL骨髓侵犯中的价值。方法回顾性分析159例NHL患者的骨髓穿刺涂片与骨髓活检结果。通过与骨髓活检比较,分析骨髓穿刺涂片诊断NHL骨髓侵犯的敏感性、特异性、一致性及临床相关性。结果骨髓穿刺涂片与骨髓活检检出NHL骨髓侵犯的符合率为83.6%,骨髓穿刺涂片的敏感性和特异性分别为53.8%和98.1%。骨髓穿刺涂片检出惰性NHL骨髓侵犯的敏感性与特异性分别为73.7%和92.0%,检出侵袭性NHL骨髓侵犯的敏感性和特异性分别为42.4%和100.0%。结论骨髓穿刺涂片是诊断NHL骨髓侵犯的一种有效方法,可作为骨髓活检的补充。

Objective To evaluate the accuracy of bone marrow morphological examination in assessing bone marrow infiltration in non-Hodgkin's lymphoma(NHL),and to evaluate the roles of bone marrow aspiration and bone marrow biopsyin the detection of bone marrow infiltration of NHL. Methods Totally,159 bone marrow specimens of patients with NHL were analyzed retrospectively. Their bone marrow aspiration and bone marrow biopsyin results were analyzed. The sensitivity,specificity,consistency and correlation of bone marrow aspiration in the detection of bone marrow infiltration of NHL were compared with those of bone marrow biopsyin. Results The consistency of bone marrow aspiration and bone marrow biopsyin was 83.6%. The sensitivity and specificity of bone marrow aspiration were 53.8% and 98.1%,respectively. For the bone marrow infiltration of indolent NHL,the sensitivity and specificity of bone marrow aspiration were 73.7% and 92.0%,respectively,while the sensitivity and specificity for the bone marrow infiltration of invasive NHL were 42.4% and 100.0%,respectively. Conclusions bone marrow aspiration is a useful method to detect bone marrow infiltration in NHL. It might be used as a supplementary measurement for bone marrow biopsyin with the advantages of easiness,rapidness and cost-effectiveness.