106例骨髓转移癌临床及细胞形态学特点分析

摘要

Objective To investigate the clinical and cell morphology features of metastatic carcinoma of bone marrow.Methods A total of 106 patients with metastatic carcinoma of bone marrow diagnosed were enrolled.The bone marrow and peripheral blood smear cytological characteristics,blood biochemical parameters and clinical manifestations were retrospectively analyzed.Results Osteodynia was the most common symptom.Hematological abnormalities included anemia and thrombocytopenia.The presences of immature erythrocyte and immature granulocyte in peripheral blood smear were demonstrated in 74％ of the patients,and 46％ of the patients had a dry pumping phenomenon undergoing bone marrow puncture.Metastatic carcinoma cells could be found as a single or formed group or cluster in the bone marrow smears in all 106 patients.Serum alkaline phosphatase and lactate dehydrogenase levels increased in 67％and 69％ of the patients,respectively.Carcinomas of unknown origin accounted for 47％,followed by gastric cancer (14％),breast cancer (11％) and prostate cancer (9％).Conclusions The possibility of metastatic carcinoma of bone marrow should be considered,if the symptoms include unexplained anemia,fever,hcmorrhage and osteodynia,with increasing alkaline phosphatase and lactate dehydrogenase,the presences of immature erythrocyte and immature granulocyte in peripheral blood smear.The bone marrow puncture is a simple and valuable method for the diagnosis of metastatic carcinoma of bone marrow.%目的 探讨骨髓转移癌患者的细胞形态学及临床特征.方法 收集106例确诊的骨髓转移癌患者,对其骨髓象、周围血象、血液生化指标及临床特点进行回顾性分析.结果 临床上最常见症状为骨痛；常见血象异常包括贫血、血小板减少,74％患者周围血出现幼粒细胞、幼红细胞；46％的患者骨髓穿刺时有干抽现象.106例患者髓象中均可找到单个或成团、成簇出现的转移癌细胞.血清碱性磷酸酶及乳酸脱氢酶升高者分别占67％和69％.原发灶不明转移癌占47％,其次为胃癌(14％)、乳腺癌(1 1％)、前列腺癌(9％)等.结论 出现原因不明的贫血、发热、出血及骨痛伴碱性磷酸酶、乳酸脱氢酶升高,且周围血出现幼红、幼粒细胞时,应考虑骨髓转移癌的可能.骨髓穿刺是简单而有效的确诊手段.