骨髓涂片联合骨髓活检诊断骨髓增生异常综合征86例

 目的　探讨骨髓穿刺涂片与骨髓活检切片同步观察对诊断骨髓增生异常综合征（MDS）的临床意义。方法　对86例MDS患者采用骨髓抽吸-活检双标本一步法取材，同步观察其涂片和切片。结果　86例MDS患者骨髓穿刺涂片增生程度极度减低至减低30例（34.88 %），活跃、明显活跃、极度活跃56例（65.12 %），红系病态造血43例（50.00 %），粒系病态造血32例（37.21 %），巨核系病态造血22例（25.58 %）。骨髓活检切片的增生程度极度减低至减低15例（17.44 %），活跃、明显活跃、极度活跃71例（82.56 %）；红系病态造血16例（18.61 %），粒系病态造血52例（60.47 %），巨核系病态造血56例（65.12 %）。86例中66例切片与涂片WHO分型诊断一致，符合率76.74 %。结论　骨髓涂片和活检在MDS的诊断和分型中各有优点，两者相互补充，二者同步观察更有利于提高MDS诊断和分型的准确性。

Bone marrow biopsy combined bone marrow smear for diagnosis of 86 MDS

Objective To explore the clinical significance of the union between marrow smear and marrow biopsy in the myelodysplastic syndrome(MDS) diagnosis. Methods Bone marrow aspirate and smear were initially abtained, then bone tissues encircled drill and section at the same point which is called as. easy one-step technology to 86 MDS patients were analysed. Results In 86 cases of MDS patients, there were 30 cases of hyperplasia extreme degree of reduction by 34.88 %, 56 eases of active, obvious and extremely active active (65.12 %), 43 cases for red RCMD (50.00 %), 32 cases for the granulocyte dysplasia (37.21%), 22 cases for megakaryocyte RCMD (25.58 %) in bone marrow aspiration smears; compared with 15 cases of hyperplasia extreme degree of reduction and the reduction (17.44 %), 71 eases of active, obviously active and extremely active (82.56 %); 16 cases for red RCMD (18.61%), 52 cases for the granulocyte dysplasia (60.47 %), 56 cases for megakaryocyte RCMD (65.12 %) in bone marrow biopsy sections. 66 cases in 86 cases of bone marrow biopsy and bone marrow smear of WHO classification were in line with the rate of 76.74 %.Conclusion The biopsy slide and the puncture smear synchronization observation is more advantageous than the conventional puncture smear morphology observation and combining two method may increase the accuracy in the MDS diagnosis.