Guan Jian-Hong, Wang Xiao-Ning, Ma Kai
Department of Hematology, the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061, Shaanxi Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2013 Aug;21(4):1054-7. doi: 10.7534/j.issn.1009-2137.2013.04.046.
This study was aimed to explore the value of one-step method of bone marrow aspiration and biopsy applied in diagnosis of the bone marrow metastatic cancer. The total of 46 cases of bone marrow metastatic cancer were analyzed retrospectively, and the results of the bone marrow smear and the bone marrow biopsies were compared. The results indicated that the success rate of one-step method of bone marrow aspiration and biopsy was 95.7%. Metastatic carcinoma cells in clumps or clusters with morphological changes were observed in the bone marrow biopsies of the 45 patients (97.8%), but the metastatic carcinoma cell clusters were observed only in bone marrow smears of the 25 patients (54.3%). There were mild to moderate hyperplasia of fibrous tissue in the patients with metastatic cancer. In addition to the 83.3% diagnostic rate of esophageal cancer, the rest diagnostic rate of bone marrow biopsy for metastatic carcinoma was 100%. The diagnostic rate of bone marrow smear for ovarian cancer, lung cancer, gastric cancer, thoracic tumor, sigmoid colon cancer, esophageal cancer and metastatic cancer of unknown primary cancers were 33.3%, 50%, 72.2%, 60%, 50%, 33.3% and 25%, respectively. The diagnostic rate of bone marrow biopsy was higher than that of bone marrow smear. It is concluded that the success rate of drawing specimen by one-step method of bone marrow aspiration and biopsy is high. The bone marrow biopsy is better than that of aspiration in diagnosis of metastatic cancer. Combining biopsy with aspiration can improve the accuracy of diagnosis.
本研究旨在探讨骨髓穿刺活检一步法在骨髓转移性癌诊断中的应用价值。回顾性分析46例骨髓转移性癌患者，比较骨髓涂片和骨髓活检结果。结果显示，骨髓穿刺活检一步法成功率为95.7%。45例患者（97.8%）的骨髓活检中观察到形态改变的成团或成簇转移癌细胞，但仅25例患者（54.3%）的骨髓涂片中观察到转移癌细胞团。转移性癌患者存在轻至中度纤维组织增生。除食管癌诊断率为83.3%外，其余骨髓活检对转移性癌的诊断率为100%。卵巢癌、肺癌、胃癌、胸段肿瘤、乙状结肠癌、食管癌及原发灶不明转移性癌的骨髓涂片诊断率分别为33.3%、50%、72.2%、60%、50%、33.3%和25%。骨髓活检诊断率高于骨髓涂片。结论：骨髓穿刺活检一步法取材成功率高。骨髓活检在转移性癌诊断中优于骨髓穿刺。活检与穿刺相结合可提高诊断准确性。
