Lu Xing-guo, Huang Lian-sheng, Xu Xiao-hua, Yang Jun-jun, Zhu Lei, Zhao Xiao-ying, Xu Gen-bo
Department of Haematol, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2006 May;35(3):331-5. doi: 10.3785/j.issn.1008-9292.2006.03.019.
To study the value of bone marrow biopsy imprint in evaluating cellularity.
The bone marrow tissues were obtained by trephine biopsy from 272 patients, and then put on the slides to make the imprints. The imprints was stained by Wright-Giemsa method, and the bone marrow smears and imprints were examined simultaneously according to the bone marrow cellularity criteria.
In bone marrow cellularity, four grades (distinct decrease, extreme decrease, distinct increase, and extreme increase) were significantly higher in bone marrow imprints than those in bone marrow smears (P <0.05), but there was no significantly differences between bone marrow imprints and sections (P >0.05). Using bone marrow sections as standard, in cellularily decreasing samples, the consistent rate of bone marrow imprints and smears were both high (84.4% and 97.9%), in the group of the normal and increased cellularity, the consistent rate of the bone marrow imprints (84.4% and 97.7%) was significantly higher than that in smears (60% and 64%, P<0.01). The sensitivity, specificity, Youden index, positive predictive value and positive likelihood rate of bone marrow imprints were all higher than those of the smears. Using the bone marrow sections as gold standard, in 124 cases with decreased cellularity in smears, the positive diagnosis rate for aplastic anemia and dyshaematopoiesis based on bone marrow imprints was 37.1% with a false positive rate of 7.3% which was lower than that of the bone marrow smears (false positive rate of 29.8%, P<0.01).
To evaluate bone marrow cellularity, bone marrow imprint is better than bone marrow smear. The combination of the two examinations can make the diagnosis more convenient and quicker.
探讨骨髓活检印片在评估骨髓细胞含量方面的价值。
对272例患者进行骨髓组织环钻活检,将组织置于载玻片上制作印片。印片采用瑞氏-吉姆萨染色法,同时依据骨髓细胞含量标准对骨髓涂片和印片进行检查。
在骨髓细胞含量方面,骨髓印片中细胞含量明显减少、极度减少、明显增多和极度增多这四个等级的比例显著高于骨髓涂片(P<0.05),但骨髓印片与切片之间无显著差异(P>0.05)。以骨髓切片为标准,在细胞含量减少的样本中,骨髓印片与涂片的符合率均较高(分别为84.4%和97.9%);在细胞含量正常和增多的组中,骨髓印片的符合率(分别为84.4%和97.7%)显著高于涂片(分别为60%和64%,P<0.01)。骨髓印片的敏感性、特异性、约登指数、阳性预测值和阳性似然比均高于涂片。以骨髓切片为金标准,在涂片细胞含量减少的124例病例中,基于骨髓印片诊断再生障碍性贫血和造血异常的阳性诊断率为37.1%,假阳性率为7.3%,低于骨髓涂片(假阳性率为29.8%,P<0.01)。
在评估骨髓细胞含量方面,骨髓印片优于骨髓涂片。两者联合检查可使诊断更便捷、快速。