摘要
目的:探讨骨髓活检在多发性骨髓瘤(MM)诊断与治疗中的价值。方法:采用骨髓抽吸-活检双标本取材法,获取骨髓活检及涂片标本,分析153例初诊MM患者的骨髓活检与涂片,对骨髓增生度、骨髓瘤细胞浸润度及浆细胞增殖模式、骨髓瘤细胞形态进行比较研究。结果:骨髓活检的增生度以及其对MM诊断的敏感性明显高于骨髓涂片,两者比较差异有统计学意义;骨髓活检骨髓瘤细胞浸润度高于骨髓涂片,两者比较差异具有统计学意义;骨髓活检中浆细胞增殖模式以间质型、结节间质型较多见,骨髓涂片中骨髓瘤细胞形态以幼稚浆细胞型为主。结论:骨髓活检能准确地反映浆细胞增殖模式,能较涂片更好地反映骨髓增生度及骨髓瘤细胞浸润度,对MM诊断的敏感性较骨髓涂片高;而骨髓涂片浆细胞形态清晰、特征典型,容易辨认。骨髓活检病理检查结合与骨髓涂片能够提高MM诊断的敏感性及准确率,对MM的早期诊断、治疗具有重要价值。
Objective：To understand the advantages and disadvantages of bone marrow biopsy pathological examination in the diagnosis of MM,define the value of bone marrow biopsy pathology in the diagnosis of MM.Methods：Use bone marrow aspiration-biopsy double specimen surgery,to get bone marrow biopsy and smears,analysis bone marrow biopsy and smears of 153 newly diagnosed MM patients,have a comparative study on bone marrow hyperplasia degree,myeloma cell infiltration,proliferation models of plasma cells and myeloma cell morphology.Result：The hyperplasia and the sensitivity of MM diagnosis of the bone marrow biopsy,is significantly higher than that of bone marrow smears,the two have a significant difference;the myeloma cell infiltration of bone marrow biopsy is higher than that of the smears,the difference has statistically significance;the proliferation mode of plasma cells in bone marrow biopsy are interstitial pattern,nodular interstitial type commonly,the myeloma cell morphology in bone marrow smears is mainly immature plasma cell type.Conclusion：Bone marrow biopsy can accurately reflect the plasma cells proliferation model,compare to smears,can have better reflection on bone marrow hyperplasia and infiltration degree,and have better sensitivity than smears on the diagnosis of MM,however,the plasma cells morphology of bone marrow smears is clear,features typical,easily identifiable.Bone marrow smears and biopsy synchronous check can improve the sensitivity and accuracy for MM diagnosis,which has very important significance for MM early diagnosis and treatment observation.
出处
《陕西医学杂志》
CAS
2016年第3期362-363,共2页
Shaanxi Medical Journal
基金
陕西省社会发展攻关基金资助项目(2011K12-23)
