Department of Pathology, Himalayan Institute of Medical Sciences, Doiwala, Dehradun, Uttarakhand, India.
Int J Lab Hematol. 2010 Oct;32(5):498-505. doi: 10.1111/j.1751-553X.2009.01212.x. Epub 2009 Jan 11.
Recently, platelet indices have been evaluated to determine their utility in knowing the mechanism of thrombocytopenia. This study was conducted to analyze the role of mean platelet volume (MPV) as a guide or an indicator for bone marrow disease in thrombocytopenic patients. All the patients with thrombocytopenia for various causes followed by bone marrow examination were divided into two groups, one group with and another without bone marrow disease, depending on pathophysiology. The MPV was statistically analyzed in both the groups to assess its role as guide for bone marrow disease in these patients. Mean MPV (average score of all individual mean values in patients) in the group with bone marrow disease was 7.3 fl, while in the group without bone marrow disease, it was 8.62 fl. Although the difference in MPV in the two groups of with (including megaloblastic anemia) and without bone marrow involvement was statistically significant (P value <0.001), its sensitivity and specificity scores as observed by receptor operating characteristic (ROC) curve at cut-off of <8.15 fl were not highly sufficient (67.7% sensitive and 65% specific). The study concluded that although MPV can be used as an initial hint for bone marrow disease in thrombocytopenic patients, it has limited sensitivity and specificity. The differentiation of megaloblastic anemia from other causes of pancytopenia involving the marrow requires bone marrow examination rather than using MPV as an indicator. Bone marrow examination remains the gold standard for discriminating hypoproductive type of thrombocytopenia from the hyperdestructive one. In addition, the role of other platelet indices should also be assessed further to know a better indicator for bone marrow involvement in thrombocytopenic patients.
最近，血小板指数已被评估用于确定其在了解血小板减少症发病机制中的作用。本研究旨在分析平均血小板体积（MPV）作为指导或指标在血小板减少症患者骨髓疾病中的作用。所有因各种原因导致血小板减少症并随后进行骨髓检查的患者均根据病理生理学分为两组，一组有骨髓疾病，另一组无骨髓疾病。对两组患者的 MPV 进行统计学分析，以评估其作为这些患者骨髓疾病指导的作用。骨髓疾病组的平均 MPV（患者所有个体平均值的平均评分）为 7.3 fl，而无骨髓疾病组为 8.62 fl。虽然两组患者（包括巨幼细胞性贫血）和无骨髓受累的 MPV 差异具有统计学意义（P 值<0.001），但其敏感性和特异性评分通过受体操作特征（ROC）曲线观察到截断值<8.15 fl 并不高（67.7%敏感，65%特异）。研究结论是，虽然 MPV 可作为血小板减少症患者骨髓疾病的初始提示，但敏感性和特异性有限。巨幼细胞性贫血与涉及骨髓的其他全血细胞减少症的鉴别需要骨髓检查，而不是将 MPV 作为指标。骨髓检查仍然是区分低生成性和高破坏性血小板减少症的金标准。此外，还应进一步评估其他血小板指数的作用，以了解更好的血小板减少症患者骨髓受累的指标。
