骨髓涂片形态对弥漫性大B细胞淋巴瘤骨髓侵犯的诊断价值  

Diagnostic value of bone marrow smear morphology in diffuse large B-cell lymphoma with bone marrow invasion

作　　者：李子艳 LI Ziyan(Department of Clinical Laboratory,Linyi Central Hospital,Linyi,Shandong,276400,China)

机构地区：[1]临沂市中心医院检验科,山东临沂276400

出　　处：《当代医学》2023年第24期149-151,共3页Contemporary Medicine

摘　　要：目的探讨骨髓涂片形态对弥漫性大B细胞淋巴瘤(DLBCL)骨髓侵犯的诊断价值。方法回顾性分析2010年1月至2021年4月本院收治的2100例DLBCL患者的临床资料,观察患者骨髓涂片形态学,比较骨髓活检与实验室检测结果及DLBCL骨髓侵犯涂片和活检的一致性。结果骨髓活检显示,发生骨髓侵犯患者235例,其中包括结旁型患者125例,散在分布型患者100例及混合型患者10例。患者Ki-67数值为3%~88%,平均为69%,其中Ki-67数值≥80%患者40例;骨髓涂片显示,骨髓侵犯患者210例,两种检查方式结果统计后,245例患者骨髓侵犯,两种检查方式用于DLBCL骨髓浸润诊断的一致性良好(Kappa=0.905);DLBCL细胞大小适中,细胞核呈圆形或不规则型,染色质颜色表现为深紫红色,核仁数量大多为1~5个;胞浆为蓝色。结论DLBCL骨髓侵犯诊断中骨髓涂片形态检查可作为有效方法,当有核细胞中不典型淋巴细胞占比超过1%,则需进一步诊断是否发生骨髓侵犯。Objective To investigate the diagnostic value of bone marrow smear morphology in diffuse large B-cell lymphoma(DLBCL)with bone marrow invasion.Methods The clinical data of 2100 DLBCL patients admitted to our hospital from January 2010 to April 2021 were retrospectively analyzed,the results of bone marrow biopsy and laboratory detection and the consistency of DLBCL smear and biopsy were compared.Results The bone marrow biopsy showed that 235 patients had bone marrow invasion,including 125 cases of paranodal patients,100 cases of scattered patients and 10 cases of mixed patients.The Ki-67 value of this group of patients was 3%-88%,with an average of 69%.Among them,40 patients had Ki-67 values≥80%;bone marrow smear showed 210 patients with bone marrow invasion,245 patients with bone marrow invasion after the results of the two examination methods were counted,and the two examination methods showed good consistency in the diagnosis of bone marrow infiltration in DLBCL(Kappa=0.905);DLBCL cells are moderate in size,the nucleus is round or irregular,and the chromatin color is dark Purple-red,the number of nucleoli is mostly 1-5;the cytoplasm is blue.Conclusion Bone marrow smear morphology examination can be used as an effective method in the diagnosis of DLBCL bone marrow invasion.When atypical lymphocytes in nucleated cells account for more than 1%,further diagnosis of bone marrow invasion is needed.

关 键 词：骨髓涂片形态 弥漫性大B细胞淋巴瘤 骨髓侵犯 诊断 骨髓活检 

分 类 号：R551.3[医药卫生—血液循环系统疾病]