骨髓活检组织病理在骨髓增生异常综合征诊断中的价值  

Value of bone marrow biopsy histopathological finding in diagnosing myelodysplastic syndrome

作　　者：浦杰[1] 陈真 石军[3] 浦权[3,4,5] 陆道培[4,5] 

机构地区：[1]桂林医学院附属医院血液病科,广西桂林541001 [2]上海市市东医院病理科,200438 [3]上海交通大学附属第六人民医院血液病科,200233 [4]复旦大学血液病中心 [5]上海道培医院,200032

出　　处：《重庆医学》2014年第3期257-259,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(81270605);上海市科学技术委员会平台项目(11140903700)

摘　　要：目的探讨塑胶包埋骨髓活检切片在骨髓增生异常综合征(MDS)诊断中的价值。方法使用乙二醇甲基丙烯酸酯(GMA)包埋骨髓活检标本,在HGF和Gomori染色下观察125例MDS骨髓切片中的病态造血和间质细胞异常反应。并以25例健康人作对照。结果活检切片可正确判定骨髓增生程度,19例(15.2%)显示幼红细胞簇异位。103例低危组病例中的64例(62%)显示幼稚前体细胞(原始和早幼粒细胞)异常定位[ALIP(+)]。单位面积内的巨核细胞和肥大细胞计数均高于对照组。Gomori染色65例示中度增加,其中10例(8.0%)骨纤程度达+++,属纤维增生型MDS。125例MDS中33例(26.4%)的骨髓活检切片内,可见红系和粒系幼稚细胞的骨髓静脉窦浸润现象。结论该研究证明,骨髓活检GMA包埋切片有助于MDS的诊断,且具有重要的临床应用价值。Objective To evaluate the value of plastic-embedded bone marrow （BM ） biopsy sections in diagnosing myelodysplas-tic syndrome（MDS） .Methods HGF and Gomori stained .Glycol methacrylate（GMA） embedded BM biopsy specimens were detec-ted from 125 MDS patients with 25 cases in good health as control .Dyshematopoiesis and abnormal stroma cell responses were se-lected as main observed projects .Results Bone marrow biopsy sections gave an exact assessment of cellularity ,19 cases （15 .2% ） showed a decrease of cellularity as hypocellular MDS .66 cases（52 .8% ） of these cases did show abnormal localization of erythro-blastic clusters ,biopsy of 64（62% ） of low risk group 103 cases did show abnormal localization of immature precursors such as blasts and promyelocytes（ALIP positive） .Numeration of megakaryocytes and mast cells within 1mm2 acre of BM tissue were all much in MDS group than in control group .Gomori′s stain revealed moderate increase in reticulin fibres in 65 cases ,10 cases（8 .0% ） showed degree of myelofibrosis were ＋ ＋ ＋ as hyperfibrotic MDS .Among 125 cases ,33 cases（26 .4% ） of bone marrow biopsies showed different types of erythrocytic and granulocytic immature cells with unusual intrasinusoidal bone marrow infiltration .Con-clusion It is clear that GMA embedded BM biopsy section is helpful in making diagnosis of MDS ,and has important clinical appli-cation value .

关 键 词：骨髓增生异常综合征 骨髓活检 组织病理 诊断 

分 类 号：R551.3[医药卫生—血液循环系统疾病]