Bauer S, Khan A, Klein A, Starasoler L
Department of Pathology and Laboratory Medicine, Beth Israel Medical Center, New York, NY 10003.
Arch Pathol Lab Med. 1992 Oct;116(10):1025-9.
Compact, lobulated megakaryocyte nuclei, apparently denuded of cytoplasm (naked nuclei), have been reported to be markedly increased in the bone marrow of persons infected with human immunodeficiency virus (HIV). We have confirmed this observation and have developed a useful diagnostic index, the naked nucleus ratio, to characterize the bone marrow of individuals who are infected with HIV. The naked nucleus ratio, calculated as the average number of naked nuclei per high-power field divided by the average number of intact megakaryocytes per high-power field, has a sensitivity of 97.9% and a specificity of 96.4% for patients with HIV infection. In our patients with a 62.6% prevalence of HIV infection, the predictive value of a positive test was 97.9% and the predictive value of a negative test was 96.4%. An increase in the naked nucleus ratio above 10%, without specific changes in the bone marrow, should raise or may confirm the suspicion of HIV infection.
据报道，在感染人类免疫缺陷病毒（HIV）的人的骨髓中，紧密、分叶状的巨核细胞核（明显无细胞质，即裸核）显著增加。我们证实了这一观察结果，并开发了一种有用的诊断指标——裸核比率，以表征感染HIV的个体的骨髓情况。裸核比率的计算方法是，每高倍视野中裸核的平均数除以每高倍视野中完整巨核细胞的平均数，对于HIV感染患者，其敏感性为97.9%，特异性为96.4%。在我们HIV感染患病率为62.6%的患者中，阳性检测的预测值为97.9%，阴性检测的预测值为96.4%。在骨髓无特异性变化的情况下，裸核比率增加超过10%，应引起或可能证实对HIV感染的怀疑。
