骨髓活检塑料包埋切片铁染色在血液病病理诊断中的意义

Significance of plastic-embedded sections of bone marrow biopsy with iron stain ing on pathologic diagnosis in various heamatological diseases

目的 研究铁染色在血液病骨髓活检病理诊断中的意义。方法 骨髓活检塑料包埋 ,半薄切片 ,Perls蓝染色 ,半定量分析。结果 584例血液病中铁染色阳性率最低者为缺铁性贫血 (0 / 7) ,此后依次为特发性血小板减少性紫癜 (6 5 % ,4/ 62 ) ,真性红细胞增多症 (9 1 % ,1 / 1 1 ) ;阳性率较高者依次为纯红细胞再生障碍性贫血 (1 0 0 % ,8/ 8) ,骨髓增生异常综合征 (75 5 % ,40 / 53) ,巨幼细胞性贫血 (60 % ,9/ 1 5)。骨髓增生异常综合征铁染色阳性率显著高于慢性再生障碍性贫血和特发性血小板减少性紫癜 (P <0 0 1 ) ,纯红细胞再生障碍性贫血铁染色阳性率显著高于慢性粒细胞白血病 (P <0 0 1 ) ,骨髓增生异常综合征铁染色阳性率显著高于骨髓增殖性疾病 (不能分类 ) (P <0 0 1 )。

Objective To study the significance of bone marrow biop sy sections with iron staining on the pathologic diagnosis in various blood diseas es Methods Plastic embedded sections of bone marrow biopsy were stained with Perls, and iron deposit were analyzed semi-quantitatively Results Among 584 cases, the lower positive percentage of iro n staining in turn were IDA (negative), ITP (6 5%,4/62), and PV (9 1%,1/11). B u t the higher positive percentage of iron staining in turn were PRCA (100%,8/8), MDS (75 5%, 40/53), MA (60 0%, 9/15) The positive percentage of bone marrow iron staining in MDS was significantly higher than those of CAA and ITP (P< 0 01;P<0 01 respectively), and the percentage in PRCA was significantly higher than that of CML (P<0 01),and that in MDS was significantly higher than unclassificable MPD (P<0 01). Conclusion Bone marrow iron staining is of important referen ce value in diagnosis and differential diagnosis in some blood diseases