Wang H Q, Shao Z H
Department of Hematology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhonghua Yi Xue Za Zhi. 2022 Mar 29;102(12):830-832. doi: 10.3760/cma.j.cn112137-20211207-02728.
As an independent disease, aplastic anemia (AA) has been recognized for more than a century. When AA is diagnosed, other non-AA bone marrow failures should be excluded. It is termed as exclusive diagnosis of AA. The exclusive diagnosis of AA is helplessly based on that there is no parameter by which AA can be sensitively and specifically diagnosed now. So further searching for the meaningful diagnostic parameters of AA should be carried on to establish a direct diagnostic protocol of this disease and make it possible to differentiate it clearly from other bone marrow failure disease such as congenenital bone marrow failure, hypoplastic myelodysplastic syndromes, AA-paroxysmal nocturnal hemoglobinuria syndromes, large granules lymphocyte leukemia, clonal cytopenia of undetermined significance, immunorelated pancytopenia, acute hemopoietic arresting and idiopathic cytopenia of undetermined significance. The new markers and technologies being helpful for distinguishing AA from other bone marrow failures should be used in diagnosing AA. Correct understanding and application of exclusive diagnosis is not only related to the correctness of diagnosis and treatment of excluded diseases, but also to the quality of AA diagnosis, treatment and research.
作为一种独立的疾病，再生障碍性贫血（AA）已被认识超过一个世纪。诊断AA时，应排除其他非AA性骨髓衰竭。这被称为AA的排他性诊断。AA的排他性诊断无奈地基于目前尚无能够敏感且特异性诊断AA的参数。因此，应继续进一步寻找AA有意义的诊断参数，以建立该病的直接诊断方案，并使其能够与其他骨髓衰竭疾病如先天性骨髓衰竭、低增生性骨髓增生异常综合征、AA-阵发性睡眠性血红蛋白尿综合征、大颗粒淋巴细胞白血病、意义未明的克隆性血细胞减少、免疫相关性全血细胞减少、急性造血停滞及意义未明的特发性血细胞减少明确区分开来。有助于将AA与其他骨髓衰竭相鉴别的新标志物和技术应用于AA的诊断中。正确理解和应用排他性诊断不仅关系到被排除疾病的诊断和治疗的正确性，也关系到AA诊断、治疗及研究的质量。
