骨髓涂片、骨髓活检对弥漫性大B细胞淋巴瘤临床分期的价值

摘要

Objective:To investigate the significance of clinical staging of diffuse large B cell lymphoma(DLBCL) in patients by bone marrow smear and bone marrow biopsy slice.Methods:Bone marrow smear and bone marrow biopsy were retrospectively analyzed in 44 patients with bone marrow involvement.The cytological morphology,tissue morphology,proliferation degree,the degree of tissue proliferation,detection rate and the sensitivity were compared between the bone marrow smear and bone marrow biopsy.Results:Bone marrow smears from visible to large atypical cells in bone marrow,with focal type is the most common tumor cells in the slice.According to evaluation of Manoharm improved method,reticular fiber content increased with different extent in bone marrow biopsy,comparison of bone marrow smear and bone marrow biopsy hyperplasia degree have significant difference (P ＜ 0.05) and slice group the degree of hyperplasia than smear group.The detection of bone marrow smear and bone marrow biopsy slice rate different was statistically significant (P ＜ 0.05) and the slice group detection rate was higher than that of group smears.The comparison between bone marrow smear and bone marrow biopsy slice sensitivity was statistically significant difference(P ＜0.01),the sensitivity of the slice group was obviously higher than that of the group smears.Conclusion:Simple bone marrow smear,bone marrow biopsy in bone marrow tissue,cell proliferation and advantage,and carry out the detection of smear and section,to improve the detection rate and can correct clinical staging,such as simultaneous flow cytometric immunophenotyping,more can improve the detection rate.%目的:探讨骨髓涂片、骨髓活检对弥漫性大B细胞淋巴瘤(DLBCL)临床分期的价值.方法:对44例累及骨髓的病例回顾性分析骨髓涂片及骨髓活检切片,分别比较细胞学形态、组织形态、增生程度、纤维组织增生程度、检出率和敏感性.结果:骨髓涂片中可见中到大型的异型细胞骨髓,切片中瘤细胞以灶型最常见.按Manoharm改良法评估,骨髓切片中网状纤维含量有不同程度增多.骨髓涂片与骨髓切片增生程度的比较,差异有统计学意义(P＜0.05),切片组增生程度高于涂片组.骨髓涂片与骨髓切片检出率的比较,差异有统计学意义(P＜0.05),切片组检出率高于涂片组.骨髓涂片与骨髓切片敏感性的比较,差异有显著统计学意义(P＜0.01),切片组敏感性明显高于涂片组.结论:骨髓涂片简单易行,骨髓切片在骨髓组织状况、优势增生细胞等方面有优势,同时开展涂片和切片的检测,提高检出率,可以修正临床分期,如能同时进行流式细胞免疫表型分析,则更能提高检出率.