CAJ | 학술논문

目的探讨骨髓涂片联合骨髓活检在全血细胞减少症中的诊断意义.方法对病因明确且同步进行骨髓涂片及骨髓活检的94例全血细胞减少症患者的临床资料进行回顾性总结.结果 94例全血细胞减少症患者中,白血病29例(30.85％),骨髓增生异常综合征(MDS) 20例(21.28％),再生障碍性贫血(AA)18例(19.15％),多发性骨髓瘤(MM)4例(4.26％),原发性骨髓纤维化症(MF)2例(2.13％),转移癌3例(3.19％),淋巴瘤骨髓浸润3例(3.19％),巨幼细胞贫血(MA)10例(10.64％),缺铁性贫血(IDA)5例(5.32％).29例白血病中,急性髓系白血病-M2型(AML-M2)5例,急性髓系白血病-M3型(AML-M3)9例,急性髓系白血病-M5型(AML-M5)6例,急性髓系白血病-M4型(AML-M4)2例,急性淋巴细胞白血病(ALL)3例,慢性淋巴细胞白血病(CLL)3例,毛细胞白血病1例.骨髓涂片诊断准确率88.30％(83/94),骨髓活检诊断准确率92.55％(87/94),骨髓涂片联合骨髓活检诊断准确率98.94％(93/94).骨髓活检诊断准确率高于骨髓涂片,但差异无统计学意义(x2=0.89,P＞ 0.05).骨髓涂片联合骨髓活检诊断准确率高于骨髓涂片,差异有统计学意义(x2=8.70,P＜0.01).骨髓涂片与骨髓活检误诊率比较差异无统计学意义[11.70％(11/94)比7.45％(7/94),x2=0.89,P＞ 0.05].结论骨髓涂片联合骨髓活检提高了血液系统疾病尤其是全血细胞减少症的诊断准确率,具有非常重要的诊断意义,应纳入常规检测项目中.
목적 탐토골수도편연합골수활검재전혈세포감소증중적진단의의.방법 대병인명학차동보진행골수도편급골수활검적94례전혈세포감소증환자적림상자료진행회고성총결.결과 94례전혈세포감소증환자중,백혈병29례(30.85％),골수증생이상종합정(MDS) 20례(21.28％),재생장애성빈혈(AA)18례(19.15％),다발성골수류(MM)4례(4.26％),원발성골수섬유화증(MF)2례(2.13％),전이암3례(3.19％),림파류골수침윤3례(3.19％),거유세포빈혈(MA)10례(10.64％),결철성빈혈(IDA)5례(5.32％).29례백혈병중,급성수계백혈병-M2형(AML-M2)5례,급성수계백혈병-M3형(AML-M3)9례,급성수계백혈병-M5형(AML-M5)6례,급성수계백혈병-M4형(AML-M4)2례,급성림파세포백혈병(ALL)3례,만성림파세포백혈병(CLL)3례,모세포백혈병1례.골수도편진단준학솔88.30％(83/94),골수활검진단준학솔92.55％(87/94),골수도편연합골수활검진단준학솔98.94％(93/94).골수활검진단준학솔고우골수도편,단차이무통계학의의(x2=0.89,P＞ 0.05).골수도편연합골수활검진단준학솔고우골수도편,차이유통계학의의(x2=8.70,P＜0.01).골수도편여골수활검오진솔비교차이무통계학의의[11.70％(11/94)비7.45％(7/94),x2=0.89,P＞ 0.05].결론골수도편연합골수활검제고료혈액계통질병우기시전혈세포감소증적진단준학솔,구유비상중요적진단의의,응납입상규검측항목중.
Objective To investigate the diagnostic significance of bone marrow smear combined with bone marrow biopsy in pancytopenia.Methods The clinical data of 94 pancytopenia patients who were detected by bone marrow smear and bone marrow biopsy synchronously were retrospectively analyzed.Results In 94 pancytopenia patients,leukemia was in 29 cases (30.85％),myelodysplastic syndrome (MDS)was in 20 cases (21.28％),aplastic anemia (AA) was in 18 cases (19.15％),multiple myeloma (MM) was in 4 cases (4.26％),primary myelofibrosis (MF) was in 2 cases (2.13％),metastatic cancer was in 3 cases (3.19％),lymphoma in bone marrow infiltration was in 3 cases (3.19％),megaloblastic anemia (MA) was in 10 cases (10.64％),and iron deficiency anemia (IDA) was in 5 cases (5.32％).In 29 leukemia patients,acute myeloid leukemia-M2 (AML-M2) was in 5 cases,acute myeloid leukemia-M3 (AML-M3) was in 9 cases,acute myeloid leukemia-M5 (AML-M55) was in 6 cases,acute myeloid leukemia-M4 (AML-M4) was in 2 cases,acute lymphoblastic leukemia (ALL) was in 3 cases,chronic lymphocytic leukemia (CLL) was in 3 cases,and hairy cell leukemia was in 1 case.The diagnostic accuracy of bone marrow smear was 88.30％ (83/94),the diagnostic accuracy of bone marrow biopsy was 92.55％ (87/94),and the diagnostic accuracy of bone marrow smear combined with bone marrow biopsy was 98.94％ (93/94).The diagnostic accuracy of bone marrow biopsy was higher than that of bone marrow smear,but there was no statistical difference (x2 =0.89,P ＞ 0.05).The diagnostic accuracy of bone marrow smear combined with bone marrow biopsy was higher than that of bone marrow smear,and there was statistical difference (x2 =8.70,P ＜ 0.01).There was no statistical difference in the misdiagnosis rate between bone marrow smear and bone marrow biopsy:11.70％ (11/94) vs.7.45％(7/94),x2 =0.89,P ＞ 0.05.Conclusions The bone marrow smear combined with the bone marrow biopsy can improve the diagnostic accuracy of the blood system diseases,especially in pancytopenia,and has a very important diagnostic significance.It should be included in routine testing project.