Departments of PathologyInternal Medicine and Biostatistics, University of New Mexico, Albuquerque, NMDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Histopathology. 2012 Oct;61(4):694-701. doi: 10.1111/j.1365-2559.2012.04259.x.
To evaluate the sensitivity and specificity of CD34 staining of megakaryocytes (MKs), in order to distinguish non-neoplastic and neoplastic bone marrows (BMs).
Three hundred BMs (120 non-neoplastic and 180 neoplastic) were evaluated for percentage and intensity of CD34 staining of MKs. The selected non-neoplastic cases included anaemia, autoimmune conditions, immune thrombocytopenia (ITP), and staging BMs. The neoplastic cases included myelodysplastic syndromes and/or myeloproliferative neoplasms (MDS, MPN, MDS/MPN). Eight per cent of non-neoplastic (9/120) cases and 13% of neoplastic (24/180) cases showed ≥30% CD34+ MKs, and these were essentially restricted to cases of megaloblastic anaemia (MBA) and non-acute myeloid neoplasms. The finding of ≥30% CD34+ MKs did not distinguish between categories of non-acute myeloid neoplasms. MDS cases with ≥30% CD34+ MKs had lower platelet counts than cases with <30% (P = 0.03).
In complex BM cases, the presence of ≥30% CD34+ MKs constitutes a potentially useful diagnostic tool with which to distinguish non-acute myeloid neoplasms and MBA from non-MBA reactive conditions, for minimal additional cost.
评估巨核细胞（MKs）中 CD34 染色的敏感性和特异性，以区分非肿瘤性和肿瘤性骨髓（BM）。
对 300 例 BM（120 例非肿瘤性和 180 例肿瘤性）进行了 MKs 中 CD34 染色的百分比和强度评估。所选的非肿瘤性病例包括贫血、自身免疫性疾病、免疫性血小板减少症（ITP）和分期 BM。肿瘤性病例包括骨髓增生异常综合征和/或骨髓增殖性肿瘤（MDS、MPN、MDS/MPN）。8%的非肿瘤性（9/120）病例和 13%的肿瘤性（24/180）病例显示≥30%的 CD34+MKs，这些病例主要局限于巨幼细胞性贫血（MBA）和非急性髓系肿瘤。≥30%的 CD34+MKs 的发现不能区分非急性髓系肿瘤的类别。≥30%的 CD34+MKs 的 MDS 病例的血小板计数低于<30%的病例（P=0.03）。
在复杂的 BM 病例中，≥30%的 CD34+MKs 的存在构成了一种潜在有用的诊断工具，可用于区分非急性髓系肿瘤和 MBA 与非 MBA 反应性疾病，且成本增加最小。
