摘要
采用塑料包埋,H-Giemsa-E染色方法对128例(结合外周血及骨髓涂片确诊的)MDS骨髓组织学进行观察,发现1.MDS骨髓大部分呈高增生(72例,56.3％),或正增生性(33例,25.8％),少数(23例,18％)为低增生性的。2.中幼阶段以上粒、红系幼稚细胞增多伴形态异常,如ALIP和“Hot spot”红系成热停滞等。3.巨核细胞分化及成熟异常,单圆核及小巨核检出率分别为96.1％和46.9％。4.伴网状纤维增多(+～+++)占53.3％,5例RAEB伴骨髓纤维化;铁染色阳性(+～+++)占31.3％。组织学分型与细胞学分型符合率为73.3％。对86例患者随访1月～7年,发现骨髓组织增生越活跃,幼稚细胞越多越易转化为白血病,但细胞学分型无此规律,且骨髓切片较涂片更早出现幼稚细胞增多。组织学分型比细胞学分型更具有预后意义。
Rone marrow hrstopathology of 128 patients with myelodysplastic syndromes(MDS). which were clinically diagnosed with peripheral blood and hone marrow smears. were observed by plastic embedding and H-Gremsa-E stain methods. It was found that : 1- most cases of MDS hone marrow showed hypercelltilarity(72 cases. 56.3%) and normocellularnty(33 cases, 25 8%),only the rest were of hypocellulanty (23 cases, 18% ). 2. the number of immature cells of promyelocyte and nor-mocyte stages with morphologic abnormalities of three lineages, such as ALIP and erythropoietic 'hot spot', etc, were increased. 3. abnormalities of differentiation and development of megakary-ocyte, mononuclear megakaryocytes and micromegakaryocytes were found in 96.1% and 46.9% ,respectively. 4.positive reticulin fibre stain( ┼ -┼ ┼ ┼) and iron stain (┼- ┤┼) were observedin 55% and 31%. respectively. Histologic classification of 73. 3% MDS was fully in accord with FAB cytologic classification. 86%eases of MDS were followed up from one month to 7 years. It was suggested that increasing of immature cells could be found earlier on section than on smear, and the more cellularity as well as the more blasts on section signified the more possibility of leukemia transformation, but this regular pattern can not be found in FAB cytologic classification. Therefore, hisfologic classification is more clinically significant for the predictive diagnosis of leukemia transformation.
出处
《天津医药》
CAS
1995年第3期131-136,共6页
Tianjin Medical Journal
