CAJ | 학술논문

目的探讨继发性骨髓纤维化(SMF)患者的临床及骨髓病理学特征.方法对69例SMF患者的临床表现、外周血涂片、骨髓涂片及骨髓活检情况进行回顾性分析,对不同疾病骨髓纤维化程度与巨核细胞数目进行相关性分析.结果 69例SMF患者原发病分别为慢性粒细胞白血病(CML)20例(29.0％),淋巴瘤14例(20.3％),急性髓系白血病(AML)、骨髓增生异常综合征(MDS)各10例(14.5％),急性淋巴细胞白血病( ALL)6例(8.7％),多发性骨髓瘤(MM)4例(5.8％),骨髓增殖性肿瘤( MPN)3例(4.3％),慢性淋巴细胞白血病(CLL)2例(2.9％).病理骨髓纤维化程度与巨核细胞数之间无相关性( r=0.024,P=0.848).结论临床上多种血液系统疾病可以引起SMF.初诊的造血系统恶性疾病患者应同时行骨髓活检,特别是脾大、骨髓“干抽”的患者要考虑SMF的可能,骨髓病理学检查对临床诊断和鉴别诊断具有重要意义.
목적 탐토계발성골수섬유화(SMF)환자적림상급골수병이학특정.방법 대69례SMF환자적림상표현、외주혈도편、골수도편급골수활검정황진행회고성분석,대불동질병골수섬유화정도여거핵세포수목진행상관성분석.결과 69례SMF환자원발병분별위만성립세포백혈병(CML)20례(29.0％),림파류14례(20.3％),급성수계백혈병(AML)、골수증생이상종합정(MDS)각10례(14.5％),급성림파세포백혈병( ALL)6례(8.7％),다발성골수류(MM)4례(5.8％),골수증식성종류( MPN)3례(4.3％),만성림파세포백혈병(CLL)2례(2.9％).병리골수섬유화정도여거핵세포수지간무상관성( r=0.024,P=0.848).결론 림상상다충혈액계통질병가이인기SMF.초진적조혈계통악성질병환자응동시행골수활검,특별시비대、골수“간추”적환자요고필SMF적가능,골수병이학검사대림상진단화감별진단구유중요의의.
Objective To study the clinical features bone marrow biopsy of secondary myelofibrosis(SMF).Methods 69 patients with secondary myelofibrosis were analyzed retrospectively,and the relationship between myelofibrosis degree and megakaryocyte count was analyzed. Results Analysis of 69 cases of patients with SMF, the original incidence included 20 cases (29.0 ％)of chronic myeloid leukemia (CML),14 (20.3 ％) cases of lymphoma,10 (14.5 ％) cases of acute myeloid leukemia (AML),10 (14.5 ％) cases of myelodysplastic syndrome (MDS),6 cases(8.7 ％)of acute lymphoblastic leukemia (ALL),4 cases of multiple myeloma (MM),3 cases of myeloproliferative neoplasms (MPN),2 cases of chronic lymphocytic leukemia (CLL).There was no significant difference of the mygakaryocytes’ count and association of myelofibrosis with it was found (r=0.024,P=0.848). Conclusion Various clinical diseases of blood system may associated with secondary myelofibrosis. Bone marrow biopsy can be used to initial diagnostics of malignant disease of hematological system patients.When cellular examination of bone marrow is dry tap or dilution, which means higher incidence of SMF. Bone marrow biopsy plays an important role in diagnosis of SMF.