骨髓抽吸-活检双标本一步法取材在骨髓转移癌诊断中的应用

本研究旨在探讨骨髓抽吸-活检双标本一步法取材在骨髓转移癌诊断中的价值。对我院46例骨髓转移癌患者采用骨髓抽吸-活检双标本一步法取材,同步分析骨髓穿刺涂片及骨髓活检组织切片结果。结果表明,骨髓抽吸-活检双标本一步法取材成功率95.7%。46例患者中45例(97.8%)骨髓活检组织切片中可观察到多少不等的成团、成簇的转移癌细胞,且可见形态异常改变。骨髓涂片中可观察到癌细胞团者占54.3%。转移癌患者骨髓活检中有不同程度的骨髓纤维组织增生,以轻中度增生为主。除食管癌中骨髓活检诊断阳性率为83.3%外,其余转移癌骨髓活检诊断阳性率为100%。骨髓涂片在卵巢肿瘤、胸椎肿瘤、肺癌、胃癌、乙状结肠癌、食管癌及不明原发灶转移癌中诊断阳性率分别为33.3%、50%、72.2%、60%、50%、33.3%和25%。骨髓活检诊断阳性率高于骨髓涂片。结论:骨髓抽吸-活检双标本一步法取材成功率高;骨髓活检在骨髓转移癌诊断方面优于骨髓涂片,将两者结合同步分析能提高诊断准确率。

One-step Method of Bone Marrow Aspiration and Biopsy Applied in Diagnosis of the Bone Marrow Metastatic Cancer

This study was aimed to explore the value of one-step method of bone marrow aspiration and biopsy applied in diagnosis of the bone marrow metastatic cancer.The total of 46 cases of bone marrow metastatic cancer were analyzed retrospectively,and the results of the bone marrow smear and the bone marrow biopsies were compared.The results indicated that the success rate of one-step method of bone marrow aspiration and biopsy was 95.7%.Metastatic carcinoma cells in clumps or clusters with morphological changes were observed in the bone marrow biopsies of the 45 patients（97.8%）,but the metastatic carcinoma cell clusters were observed only in bone marrow smears of the 25 patients（54.3%）.There were mild to moderate hyperplasia of fibrous tissue in the patients with metastatic cancer.In addition to the 83.3% diagnostic rate of esophageal cancer,the rest diagnostic rate of bone marrow biopsy for metastatic carcinoma was 100%.The diagnostic rate of bone marrow smear for ovarian cancer,lung cancer,gastric cancer,thoracic tumor,sigmoid colon cancer,esophageal cancer and metastatic cancer of unknown primary cancers were 33.3%,50%,72.2%,60%,50%,33.3% and 25%,respectively.The diagnositic rate of bone marrow biopsy was higher than that of bone marrow smear.It is concluded that the success rate of drawing speciment by one-step method of bone marrow aspiration and biopsy is high.The bone marrow biopsy is better than that of aspiration in diagnosis of metastatic cancer.Combining biopsy with aspiration can improve the accuracy of diagnosis.