外周血涂片骨髓细胞形态及骨髓活检联合检测对骨髓增生异常综合征的诊断价值  

Diagnostic Value of Combined Detection of Peripheral Blood Smear Bone Marrow Cell Morphology and Bone Marrow Biopsy for Myelodysplastic Syndrome

作　　者：朱晓华[1] 王建成[1] 程彦[1] 窦立萍 ZHU Xiaohua;WANG Jiancheng;CHENG Yan(Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China)

机构地区：[1]首都医科大学附属北京友谊医院检验科,北京100050 [2]中国人民解放军总医院海南分院检验科,海南三亚572014

出　　处：《河北医学》2021年第6期906-910,共5页Hebei Medicine

基　　金：海南省自然科学基金面上项目,(编号:818ms157)。

摘　　要：目的:探究外周血涂片、骨髓细胞形态及骨髓活检联合检测对骨髓增生异常综合征(MDS)的诊断价值,旨在为MDS早期诊治提供参考。方法:病例源于2016年1月至2020年1月本院收治的108例疑似MDS患者,患者均接受外周血涂片、骨髓细胞形态及骨髓活检检测,以随访资料结果为金标准,评估外周血涂片、骨髓细胞形态、骨髓活检及三者联合检测诊断MDS及其分型的价值。结果:外周血涂片、骨髓细胞形态及骨髓活检三者联合检测诊断MDS的效能(Kappa值)较三者单项检测的高,外周血涂片、骨髓细胞形态、骨髓活检及三者联合检测诊断MDS的灵敏度较三者单项检测的明显高(P<0.05),以随访结果为金标准,外周血涂片、骨髓细胞形态及骨髓活检联合检测诊断MDS分型的准确率为84.62%(66/78)。结论:外周血涂片、骨髓细胞形态及骨髓活检联合检测可有效提高MDS诊断的灵敏度和准确度,且三者联合检测对MDS分型诊断的准确率高,有望为MDS治疗方案选择和预后评估提供参考。Objective:To investigate the diagnostic value of combined detection of peripheral blood smear,bone marrow cell morphology and bone marrow biopsy for myelodysplastic syndrome(MDS),aiming at providing reference for early diagnosis and treatment of MDS.Methods:108 patients with suspected MDS admitted to the hospital from January 2016 to January 2020 were selected as subjects.All patients underwent peripheral blood smear,detection of bone marrow cell morphology and bone marrow biopsy.With follow-up data as the golden standard,the value of combined detection of peripheral blood smear,bone marrow cell morphology and bone marrow biopsy for diagnosis and classification of MDS was evaluated.Results:The efficiency(Kappa value)of combined detection of peripheral blood smear,bone marrow cell morphology and bone marrow biopsy in the diagnosis of MDS was higher than that of single detection.The sensitivity was significantly higher than that of single detection(P<0.05).With follow-up data as the golden standard,the accuracy of combined detection of peripheral blood smear,bone marrow cell morphology and bone marrow biopsy for classification of MDS was 84.62%(66/78).Conclusion:The combination detection of peripheral blood smear,bone marrow cell morphology and bone marrow biopsy can effectively improve the diagnostic sensitivity and accuracy for MDS.The accuracy of combined detection is also high in the classification of MDS.It is expected to provide reference for selection of treatment plan for MDS and prognosis evaluation.

关 键 词：骨髓细胞形态 外周血涂片 骨髓活检 骨髓增生异常综合征 

分 类 号：R73[医药卫生—肿瘤]