多发性骨髓瘤合并骨髓纤维化的病理及临床研究  

Pathological and clinical study of multiple myeloma with myelofibrosis

作　　者：蒋秦燕[1] 李晓[1] 常春康[1] 黄薇[1] 苏基滢[1] 陶英[1] 刘薏芝[1] 浦权[1] 

机构地区：[1]上海市第六人民医院,上海交通大学附属第六人民医院血液科,200233

出　　处：《上海医学》2002年第z1期44-45,共2页Shanghai Medical Journal

摘　　要：目的　观察多发性骨髓瘤合并骨髓纤维化的发生率及骨髓纤维化对诊断和预后的影响。方法　回顾性检测 96例多发性骨髓瘤的骨髓切片 ,骨髓网硬蛋白纤维 (Gomori染色 ) ++以上定为骨髓纤维化 ,并对其重要特点及临床检验进行分析。结果　 96例多发性骨髓瘤中合并骨髓纤维化 12例 ,发病率为 12 .5 % ,12例中7例骨髓切片与骨髓涂片细胞增生度不符 ,4例骨髓切片与骨髓涂片细胞分型不符 ,除外周血常规三系下降外 ,生化指标和预后与不伴有骨髓纤维化的多发性骨髓瘤差异无显著性。结论　骨髓活检切片是判定多发性骨髓瘤合并骨髓纤维化的有效手段 ,对正确判断多发性骨髓瘤增生程度及肿瘤细胞分化程度有重要意义。Objective To observe the incidence of multiple myeloma(MM) with accompanying myelofibrosis(MF) and the latter's influence on diagnosis and prognosis of MM.Methods Marrow biopsy and reticulo-fibro protein staining(Gomori staining) >2+ were considered to have MF. The essential clinical and pathologic features in 96 cases of MM were analyzed.Results Among these, 12 cases were found to have MF, an incidence of 12.5%. In the 12 cases, the biopsy findings was not concordant with the degree of proliferation in marrow smear, in four, the marrow biopsy findings were discordant with the cellular types. Except the pancytopenia in the peripheral blood, there was no significant difference between MM with and without MF, as shown by biochemical parameters and their prognosis.Conclusion Bone marrow biopsy is an effective measure in the diagnosis of MM with accompanying MF, it can correctly assess the degree of proliferation and differentiation of the tumor.

关 键 词：多发性骨髓瘤 骨髓纤维化 骨髓增殖性疾病 

分 类 号：R733.3[医药卫生—肿瘤]