检验医学
檢驗醫學
검험의학
LABORATORY MEDICINE
2010年
2期
103-106
,共4页
骨髓象%癌细胞%肿瘤转移
骨髓象%癌細胞%腫瘤轉移
골수상%암세포%종류전이
Myelogram%Carcinoma cell%Tumor metastasis
目的 探讨通过骨髓象检查诊断骨髓转移癌的价值,以及骨髓转移癌骨髓象变化的特点.方法 常规髂前或髂后上棘抽取骨髓液涂片,同时制备血涂片,行瑞-姬复合染色后显微镜检查,找到转移癌(瘤)细胞,即诊断为骨髓转移癌(瘤).结果 64例患者均由骨髓涂片骨髓象检查发现癌(瘤)细胞而确诊.其中1次检查即明确诊断者52例(81.2%),2次检查明确诊断者11例(17.2%),3次检查明确诊断者1例(1.6%).癌(瘤)细胞主要出现在涂片的尾部及边缘,有17例(26.6%)涂片所见主要为癌(瘤)细胞.根据涂片中出现的癌(瘤)细胞的形态、排列方式,结合临床表现,骨髓象检查诊断为癌细胞骨髓转移(未分类)32例(50.0%),腺癌骨髓转移29例(45.3%),神经母细胞瘤骨髓转移3例(4.7%).结论 诊断恶性肿瘤骨髓转移,骨髓象检查阳性率高,简便易行,只要涂片中找到癌(瘤)细胞,即可直接获得骨髓转移癌的病理诊断.但当骨髓有核细胞增生活跃,癌细胞单个散在或癌细胞团不典型时,诊断及判断细胞来源需慎重.
目的 探討通過骨髓象檢查診斷骨髓轉移癌的價值,以及骨髓轉移癌骨髓象變化的特點.方法 常規髂前或髂後上棘抽取骨髓液塗片,同時製備血塗片,行瑞-姬複閤染色後顯微鏡檢查,找到轉移癌(瘤)細胞,即診斷為骨髓轉移癌(瘤).結果 64例患者均由骨髓塗片骨髓象檢查髮現癌(瘤)細胞而確診.其中1次檢查即明確診斷者52例(81.2%),2次檢查明確診斷者11例(17.2%),3次檢查明確診斷者1例(1.6%).癌(瘤)細胞主要齣現在塗片的尾部及邊緣,有17例(26.6%)塗片所見主要為癌(瘤)細胞.根據塗片中齣現的癌(瘤)細胞的形態、排列方式,結閤臨床錶現,骨髓象檢查診斷為癌細胞骨髓轉移(未分類)32例(50.0%),腺癌骨髓轉移29例(45.3%),神經母細胞瘤骨髓轉移3例(4.7%).結論 診斷噁性腫瘤骨髓轉移,骨髓象檢查暘性率高,簡便易行,隻要塗片中找到癌(瘤)細胞,即可直接穫得骨髓轉移癌的病理診斷.但噹骨髓有覈細胞增生活躍,癌細胞單箇散在或癌細胞糰不典型時,診斷及判斷細胞來源需慎重.
목적 탐토통과골수상검사진단골수전이암적개치,이급골수전이암골수상변화적특점.방법 상규가전혹가후상극추취골수액도편,동시제비혈도편,행서-희복합염색후현미경검사,조도전이암(류)세포,즉진단위골수전이암(류).결과 64례환자균유골수도편골수상검사발현암(류)세포이학진.기중1차검사즉명학진단자52례(81.2%),2차검사명학진단자11례(17.2%),3차검사명학진단자1례(1.6%).암(류)세포주요출현재도편적미부급변연,유17례(26.6%)도편소견주요위암(류)세포.근거도편중출현적암(류)세포적형태、배렬방식,결합림상표현,골수상검사진단위암세포골수전이(미분류)32례(50.0%),선암골수전이29례(45.3%),신경모세포류골수전이3례(4.7%).결론 진단악성종류골수전이,골수상검사양성솔고,간편역행,지요도편중조도암(류)세포,즉가직접획득골수전이암적병리진단.단당골수유핵세포증생활약,암세포단개산재혹암세포단불전형시,진단급판단세포래원수신중.
Objective To explore the diagnostic value for bone marrow metastatic carcinoma by the examination of myelogram and the characteristic of myelogram change of bone marrow metastatic carcinoma. Methods The patients′bone marrows were taken routinely. Bone marrow smears and blood smears were made by Wright and Giemsa staining and the finding of carcinoma (tumor) cells meant that there was bone marrow metastatic carcinoma (tumor). Results 64 patients were all diagnosed by finding the metastatic carcinoma (tumor) cells in the bone marrow smears. 52 cases were diagnosed clearly in the first examination(81.2%), and 11 cases in the second examination(17.2%)and 1 case in the third examination(1.6%) were diagnosed. Metastatic carcinoma (tumor) cells scattered mainly on the tails and rims of the smears and there were mainly carcinoma (tumor) cells in 17 cases (26.6%). According to the morphology and arrangement manner of the carcinoma (tumor) cells in the smears, combining the clinical features, the final diagnosis of myelogram included 32 cases carcinoma cells bone marrow metastasis(unclassified, 50.0%),29 cases adenocarcinoma bone marrow metastasis(45.3%)and 3 cases neuroblastoma bone marrow metastasis (4.7%). Conclusions Myelogram has a higher positive rate, the characteristic of simpleness and the practical approach to the diagnosis of bone marrow matastatic carcinoma (tumor) methods. However, we should be caution in the diagnosis and judgement of the cell source when we see single scattered cancer cell or atypical cancer cell mass.
