骨髓涂片、骨髓活组织检查及流式细胞术在淋巴瘤骨髓侵犯诊断中的比较

目的 比较骨髓涂片、骨髓活组织检查和流式细胞术三种方法对淋巴瘤患者骨髓受累的检测情况,为临床检测骨髓受累提供选择.方法 收集68例恶性淋巴瘤初治患者,观察骨髓涂片、骨髓活组织检查和流式细胞术三种方法检测淋巴瘤患者骨髓受累的阳性率.结果 68例恶性淋巴瘤患者检测骨髓受累时,骨髓涂片、骨髓活组织检查和流式细胞术的阳性率分别为16.2％（11/68）、33.8％（23／68）和10.3 ％（7/68）,骨髓活组织检查阳性率高于涂片和流式细胞术检查,三种方法阳性率差异有统计学意义（P＜0.05）.对三种检测方法进行相关性分析,骨髓涂片与骨髓活组织检查存在相关性（P=0.002）,与流式细胞术没有相关性（P=0.270）.结论 骨髓涂片细胞形态学检查是检测淋巴瘤患者是否有骨髓受累的基础方法,骨髓活组织检查阳性率较高,有明显的优势,但需与骨髓涂片互为补充.

Comparison of bone marrow smear,biopsy and flow cytometry in diagnosis of lymphoma patients with bone marrow involvement

Objective To compare the effectiveness,correlativity,and acceptability of the three methods：bone marrow smear,biopsy and flow cytometry in diagnosis of lymphoma patients with bone marrow involvement.Methods 68 cases of early stage lymphoma were studied by observing and comparing positive rates of the three methods：bone marrow smear,biopsy and flow cytometry.Results After confirming the bone marrow involvement,the positive rates for the 68 cases using bone marrow smear,biopsy and flow cytometry were 16.2 ％ （11/68）,33.8 ％ （23/68） and 10.3 ％ （7/68） respectively.Bone marrow biopsy had the highest positive rate compared to the other methods.It was statistically significant when comparing the differences of the 3 methods （P ＜ 0.05）.According to the correlativity analysis of the 3 methods,bone marrow smear and biopsy correlated with each other （P =0.002）,while flow cytometery did not （P =0.270）.Conclusions Morphological examination of the bone marrow smear is a fundamental method to test bone marrow involvement in lymphoma.Bone marrow biopsy creates the highest positive rate and has clear advantage compared to the other methods,however,bone marrow smear must be used at the same time as a complement.