骨髓组织印片在浆细胞骨髓瘤形态学诊断中的价值

目的 了解骨髓组织印片在浆细胞骨髓瘤诊断中的应用价值.方法 收集同步进行骨髓涂片、组织印片和切片检查的98例浆细胞骨髓瘤,比较骨髓涂片、组织印片和切片在有核细胞量、浆细胞百分比、浸润度及诊断符合率的差异.结果 骨髓组织印片显示有核细胞量评估性能优于涂片（P＜0.05）,而与切片相近（P＞0.05）;骨髓组织印片显示浆细胞含量高于涂片（P＜0.05）;骨髓组织印片显示浸润度优于涂片（P＜0.05）,而与切片相近（P＞0.05）;骨髓涂片由于受稀释或干抽等因素影响符合率仅为83.7％,而骨髓组织印片诊断符合率高达98.9％,骨髓组织印片诊断符合率优于骨髓涂片（P＜0.05）.结论 骨髓组织印片兼有涂片和切片的特征;组织印片联合涂片互补性检查,对浆细胞骨髓瘤形态学诊断具有明显优势.

Application of bone marrow biopsy imprints in diagnosis of plasma cell myeloma

Objective To evaluate the application of bone marrow biopsy imprints in diagnosis of plasma cell myeloma. Methods Marrow smears, bone marrow biopsy imprints and sections of 98 patients with plasma cell myeloma were collected. The amount of nucleated cells, the percentage of malignant cells, degree of invasion and diagnostic accordance rate were compared. Results The amount of nucleated cells in imprints were higher than that of smears （P〈0.05） and close to that of sections （P 〉0.05）; the percentage of plasma cells in imprints were also higher than that of smears （P〈0.05）. With the results of sections as gold standard, the degree of plasma cell invasion diagnosed by imprints was more accurate than that of smears （P〈0.05）, the diagnostic accordance rate of imprint was higher than that of marrow smears （98.9%, 83.7%, P〈0.05）. Conclusion Biopsy imprints are complementary to smear and section examinations, the combination of imprints and smears may be of advantage in morphological diagnosis of plasma cell myeloma.