中国医师杂志
中國醫師雜誌
중국의사잡지
JOURNAL OF CHINESE PHYSICIAN
2014年
11期
1517-1520
,共4页
施国美%莫伟明%陈燕%楚旭
施國美%莫偉明%陳燕%楚旭
시국미%막위명%진연%초욱
骨髓检查/方法%活组织检查%细胞诊断学%血液病/诊断
骨髓檢查/方法%活組織檢查%細胞診斷學%血液病/診斷
골수검사/방법%활조직검사%세포진단학%혈액병/진단
Bone marrow examination/methods%Biopsy%Cytodiagnosis%Hematologic diseases/diagnosis
目的 研究骨髓组织印片在细胞形态学诊断中的应用价值.方法 收集2011年1月至2013年12月354份同步进行骨髓涂片、印片和切片检查的临床标本进行对比研究,分析形态学诊断差异性.结果 骨髓组织印片在极度减少、明显减少、正常、轻度增多、明显增多、极度增多组中有核细胞量评估性能优于涂片(P＜0.01),而与切片相近(P＞0.05).印片有核细胞数量减少者涂片大多减少,而涂片细胞减少者印片大多正常或增加.以骨髓切片有核细胞量变化为标准,有核细胞减少组中涂片与印片符合率均较高(87.5％和96.9％);有核细胞量正常及增多组中印片符合率均高于涂片(87.8％和95.7％ vs 68.3％和55.8％),其差异均有统计学意义(P＜0.01).印片敏感度、特异度及约登指数指标性能评价总体上也优于涂片.浆细胞骨髓瘤(PCM)患者中印片浆细胞总量及幼稚浆细胞量高于涂片(42.73±10.47和13.60±4.83 vs 24.67±11.18和11.07±5.82),其差异均有统计学意义(P＜0.05).结论 骨髓组织印片兼有涂片和切片的特征,印片在评估有核细胞量及肿瘤细胞浸润度等方面优于涂片,骨髓涂片与印片快速联检可以提高骨髓细胞形态学诊断水平.
目的 研究骨髓組織印片在細胞形態學診斷中的應用價值.方法 收集2011年1月至2013年12月354份同步進行骨髓塗片、印片和切片檢查的臨床標本進行對比研究,分析形態學診斷差異性.結果 骨髓組織印片在極度減少、明顯減少、正常、輕度增多、明顯增多、極度增多組中有覈細胞量評估性能優于塗片(P＜0.01),而與切片相近(P＞0.05).印片有覈細胞數量減少者塗片大多減少,而塗片細胞減少者印片大多正常或增加.以骨髓切片有覈細胞量變化為標準,有覈細胞減少組中塗片與印片符閤率均較高(87.5％和96.9％);有覈細胞量正常及增多組中印片符閤率均高于塗片(87.8％和95.7％ vs 68.3％和55.8％),其差異均有統計學意義(P＜0.01).印片敏感度、特異度及約登指數指標性能評價總體上也優于塗片.漿細胞骨髓瘤(PCM)患者中印片漿細胞總量及幼稚漿細胞量高于塗片(42.73±10.47和13.60±4.83 vs 24.67±11.18和11.07±5.82),其差異均有統計學意義(P＜0.05).結論 骨髓組織印片兼有塗片和切片的特徵,印片在評估有覈細胞量及腫瘤細胞浸潤度等方麵優于塗片,骨髓塗片與印片快速聯檢可以提高骨髓細胞形態學診斷水平.
목적 연구골수조직인편재세포형태학진단중적응용개치.방법 수집2011년1월지2013년12월354빈동보진행골수도편、인편화절편검사적림상표본진행대비연구,분석형태학진단차이성.결과 골수조직인편재겁도감소、명현감소、정상、경도증다、명현증다、겁도증다조중유핵세포량평고성능우우도편(P＜0.01),이여절편상근(P＞0.05).인편유핵세포수량감소자도편대다감소,이도편세포감소자인편대다정상혹증가.이골수절편유핵세포량변화위표준,유핵세포감소조중도편여인편부합솔균교고(87.5％화96.9％);유핵세포량정상급증다조중인편부합솔균고우도편(87.8％화95.7％ vs 68.3％화55.8％),기차이균유통계학의의(P＜0.01).인편민감도、특이도급약등지수지표성능평개총체상야우우도편.장세포골수류(PCM)환자중인편장세포총량급유치장세포량고우도편(42.73±10.47화13.60±4.83 vs 24.67±11.18화11.07±5.82),기차이균유통계학의의(P＜0.05).결론 골수조직인편겸유도편화절편적특정,인편재평고유핵세포량급종류세포침윤도등방면우우도편,골수도편여인편쾌속련검가이제고골수세포형태학진단수평.
Objective To investigate the value of bone marrow imprints in the cytomorphology diagnosis.Methods A total of 354 cases of bone marrow smears,imprints,and sections were analyzed from January 2011 to December 2013 to detect morphological diagnosis difference.Results Bone marrow imprints in groups of extremely reduced,significantly reduced,normal,slightly increased,increased significantly,and extreme increase were better than that of smear which nucleated cells quantity assessment(P ＜ 0.01).Smears and imprints were similar (P ＞0.05).Imprints nucleated cell number decreased mostly were the same as smear,but smear reduced imprints mostly normal or increased.The bone marrow sections nucleated cells quantity as the standard,smears and imprints had high coincidence rate in the group of nucleated cells reduced (87.5％ and 96.9％),and imprints were higher than smear in the group of nucleated cells quantity in normal and increased(87.8％ and 95.7％ vs 68.3％ and 55.8％),and the difference was statistically significant.Imprints were better than smear in specificity,Youden index,and sensitivity.Patients with plasma cell myeloma (PCM) imprint plasma cell volume and immature plasma cells were higher than that of smear (42.73 ± 10.47 and 13.60 ± 4.83 vs 24.67 ± 11.18 and 11.07 ± 5.82) with a statistically significant difference (P ＜ 0.05).Conclusions Imprints have characteristics both smear and sections,and imprints are superior to smears in assessment of nucleated cells and tumor cell invasion degree.Smear combined with imprints can improve the diagnosis level of bone marrow cell cytomorphology.
