Nanda Annu, Basu Sabita, Marwaha Neelam
Department of Haematology and Transfusion Medicine, Government Medical College, Chandigarh.
J Assoc Physicians India. 2002 Jul;50:893-5.
To determine the relative efficacy of bone marrow aspiration as compared to that of trephine biopsy.
Bone marrow aspiration and bilateral trephine biopsies were performed in 420 consecutive cases. The diagnosis and findings made on bone marrow aspiration were compared with that made on trephine biopsy in each case.
Aspiration alone was sufficient in making a diagnosis in 372 (88.6%) cases as it correlated well with the diagnosis made on trephine sections. In the remaining 48 (11.4%) cases trephine biopsy was necessary for making a diagnosis due to incomplete information provided by aspiration or its inability to give a correct diagnosis. These cases were mostly hypoplastic/aplastic marrow, myelofibrosis and marrow involvement by metastatic tumour and lymphomatous infiltration. Often a bilateral marrow biopsy picked up the diagnostic lesion.
The decision to perform a marrow aspiration alone or in combination with marrow biopsy depends on the diagnosis being considered. In nutritional anaemias, most hematologic malignancies and immune thrombocytopenias, marrow aspiration alone is sufficient, but for detection of disorders with focal marrow involvement bilateral marrow biopsies are a must.
确定骨髓穿刺术与环钻活检术相比的相对疗效。
对420例连续病例进行了骨髓穿刺和双侧环钻活检。将每例骨髓穿刺的诊断和结果与环钻活检的诊断和结果进行比较。
仅穿刺就足以在372例（88.6%）病例中做出诊断，因为其与环钻切片的诊断相关性良好。在其余48例（11.4%）病例中，由于穿刺提供的信息不完整或无法做出正确诊断，需要进行环钻活检以做出诊断。这些病例大多为增生低下/再生障碍性骨髓、骨髓纤维化以及转移性肿瘤和淋巴瘤浸润累及骨髓。双侧骨髓活检常常能发现诊断性病变。
单独进行骨髓穿刺或与骨髓活检联合进行的决定取决于所考虑的诊断。在营养性贫血、大多数血液系统恶性肿瘤和免疫性血小板减少症中，仅骨髓穿刺就足够了，但对于检测有局灶性骨髓受累的疾病，双侧骨髓活检是必需的。
