864例血液病人骨髓切片的临床分析

The significance of trephine biopsy in clinical applying of haematological disorders - the analysis of 864 patients with bone marrow biopsies

目的 探讨骨髓活检在血液病诊断和疗效判断中的价值,并分析切片相对于涂片的优点和不足。方法 对864例骨髓活检组织的病理变化进行了分析,部分结合免疫组织化学。结果 在早期白血病的诊断、判断慢性粒细胞白血病急变、MDS诊断及转归、恶性肿瘤的骨髓浸润方面,骨髓活检优于涂片;而对于白血病的FAB分型、巨幼红细胞性贫血、缺铁性贫血等的诊断,骨髓活检存在不足之处。结论 骨髓活检对许多血液病的诊断、预后、分期有重要价值。

Objective To study the value of trephine biopsy in haematological disorders and discuss the advantages and shortages of bone marrow biopsy and aspiration, Methods The pathologic changes of 864 bone marrow biopsies were analysed, some case combined with im-munophentypes analysis. Results The biopsies showed the changes earlier than aspiration estecially in the early leukemia, the blast crisis in chronic granulocytic leukenia and the diagnosis and the evolution myelodisplastic syndrome, metastatic tumor. however, therea have deficiencies in FAB classification of acute lerkemia, the diagnosis of megaloblastic anemia and irondeficiency anemia. Conclusions The trephine biopsy play an implrtment role in the diagnosis, prognosis and stage in many haematlolgical disorders.