骨髓增殖性肿瘤临床病理学特征分析

目的探讨骨髓增殖性肿瘤的骨髓病理组织形态学特点,探讨其临床诊断价值。方法选取2020年1月至2023年3月本院收治的MPN患者138例,对骨髓活检组织作组织学观察及免疫组化行表型分析,同时进行基因学检测。结果138例确诊MPN患者中,BCR ABL阳性CML 39例,BCR ABL阴性MPNs中PV 13例、ET 72例和PMF 11例。经典型MPN骨髓活检组织各具有诊断性形态学特点。CML粒红系比例明显增大伴粒系核右移,巨核细胞均为胞体小、分叶少的巨核细胞,PV粒红系比例明显减小,巨核细胞形态多样,混杂分布;ET粒红系比例大致正常,巨核细胞则为胞体大、分叶多的巨核细胞;PMF巨核细胞形态怪异,核染色质深染浓集,多伴网状纤维显著性增生。结论骨髓活检组织形态在MPN精准诊断和分型中具有重要临床意义。

Objective To explore the value of histopathology at the diagnosis of myeloproliferative neoplasms(MPN)and analyze its clinical diagnostic value.Methods Routine histologic examination and immunohistochemically analyzed was performed on bone marrow biopsies,and molecular biological detection was also performed.Results Among the 138 confirmed MPN patients,42 were BCR ABL-positive CMLs,and BCR ABL-negative MPNs included 13 PVs,72 ETs and 11 PMFs.The typical MPN bone marrow biopsy tissue had diagnostic morphological characteristics,were all characterized by the proliferation and change of megakaryocytes.Conclusion The histopathology of bone marrow biopsy has important clinical significance in the accurate diagnosis and differential diagnosis of MPNs.