细胞形态学异常在骨髓增生异常综合征的诊断价值  

The Diagnostic Value of Abnormal Cell Morphology in the Myelodysplastic Syndrome

作　　者：邢丽丽[1] 秦卫玲[1] 窦敬芳[1] 邢会茹 郑辉[1] 牛新清[1] 

机构地区：[1]新乡医学院第三附属医院,河南新乡453000

出　　处：《河南科技大学学报（医学版）》2016年第1期12-15,共4页Journal of Henan University of Science & Technology:Medical Science

基　　金：河南省教育厅自然科学基金(2010A320012)

摘　　要：目的探讨细胞形态学异常对骨髓增生异常综合征(MDS)的诊断价值。方法采用瑞氏-姬姆萨染色法对35例MDS患者及35例非克隆性疾病患者外周血及骨髓细胞涂片染色,比较两组外周血及其骨髓细胞的形态特征。结果外周血细胞形态学病态检查结果中,观察组原粒细胞、幼粒细胞、幼红细胞及巨核细胞形态异常发生比例均明显高于对照组(均为P<0.05)。骨髓粒细胞系指标中,观察组原粒细胞、Auer小体、核出芽、核空泡、胞质颗粒异常、假性Pelger-Huet样核异常细胞、高分叶、核浆发育不平行发生比例均明显高于对照组(均为P<0.05);红细胞系指标中,观察组核间桥、花瓣核、Hb充盈减少、多核、核出芽、细胞大小不均、幼红细胞、核碎裂、大红细胞、巨幼红细胞发生比例均明显高于对照组(均为P<0.05);巨核细胞系指标中,观察组单圆核发生比例、多圆核发生比例、淋巴样小巨核发生比例、畸形血小板发生比例均明显高于对照组(P<0.05)。2例(5.7%)RA患者外周血及骨髓细胞未见明显细胞形态病态改变。结论细胞形态学异常是诊断MDS的最重要和基础的手段,部分病例在早期需结合其他检测技术以提高诊断准确率。Objective To explore the diagnostic value of cell morphological abnormalities in myelodysplastic syndrome （MDS）. Methods There were stained with Wright Giemsa in 35 cases of MDS patients and 35 cases of patients with non clonal disorders peripheral blood and bone marrow smears, and compared with peripheral blood and bone marrow cell morphological characteristics between the two groups of patients. Results The incidence of the myeloblast, promyelocyte, erythroblasts and megalokaryocyte in the observation group were significantly higher than those in the control group （P 〈 0.05）. The incidence of myeloblast, Auer rods, nuclear budding, nuclear vacuoles, abnormal granules in the cytoplasm, pseudo Pelger-Huet like abnormal nucleus cell, high leaf abnormal cell, nucleocytoplasmic development non parallel were significantly higher than those of the control group in granulocytic series （P 〈 0.05） ; The incidence of erythrocytic series on nuclear bridge, petals nuclear, Hb filling reduced, polynuclear, nuclear budding, cell size unevenness, erythroblasts, nuclear fragmentation, macrocyte, megaloblast were significantly higher than those in the control group （P 〈 0.05）. The incidence of single round nucleus, multi round nucleus, lymphoid micromega-karyocyte, platelet abnormalities on megakaryocyte series in observed group was significantly higher than that of the control group （P 〈 0.05）. 2 patients （5.7%） had no obvious pathological changes in peripheral blood and bone marrow cells of refractory anemia patients. Conclusion Abnormal cell morphology was the most important and basic method in the diagnosis of MDS, and some cases could be combined with other detection technology to improve the accuracy of MDS diagnosis.

关 键 词：细胞形态学 骨髓增生异常综合征 诊断价值 

分 类 号：R551.3[医药卫生—血液循环系统疾病]