Crisan D, Farkas D H
Department of Clinical Pathology, William Beaumont Hospital, Royal Oak, MI 48073.
Ann Clin Lab Sci. 1993 Nov-Dec;23(6):407-22.
Bone marrow (BM) biopsies occasionally fail to yield aspirate specimens; such "dry taps" pose diagnostic difficulties. In the absence of a BM aspirate, morphological evaluation and cytochemistry rely on core biopsy imprint preparations (IP) and other analyses, e.g., molecular pathology studies, become impossible. The use of imprint preparations (IPs) for molecular diagnostics based on messenger ribonucleic acid (mRNA) analysis by reverse transcription-polymerase chain reaction (RT-PCR) for detection of breakpoint cluster region (bcr) gene rearrangements in chronic myelogenous leukemia (CML) and myeloperoxidase (MPO) mRNA in acute leukemias (AL) is described. Fifteen IPs from five core biopsies (three CML and two AL) were used. Analysis of bcr was positive in all nine IPs from the three cases of CML and was confirmed on peripheral blood samples. Detection of MPO mRNA established the myeloid lineage of the blasts in two cases of AL, when cytochemistry and flow cytometry failed to reveal myeloid markers. These tests are useful when fresh BM aspirate is unobtainable, since multiple imprints of the biopsy are easily prepared at the bedside.
骨髓活检偶尔无法获取抽吸标本；这种“干抽”会带来诊断困难。在没有骨髓抽吸物的情况下，形态学评估和细胞化学依赖于核心活检印片制备物（IP），而其他分析，如分子病理学研究，则无法进行。本文描述了使用印片制备物（IP）通过逆转录聚合酶链反应（RT-PCR）基于信使核糖核酸（mRNA）分析进行分子诊断，以检测慢性粒细胞白血病（CML）中的断裂点簇集区（bcr）基因重排以及急性白血病（AL）中的髓过氧化物酶（MPO）mRNA。使用了来自五例核心活检（三例CML和两例AL）的15个IP。在三例CML的所有九个IP中，bcr分析均为阳性，并在外周血样本中得到证实。在两例AL中，当细胞化学和流式细胞术未能显示髓系标志物时，MPO mRNA的检测确定了原始细胞的髓系谱系。当无法获得新鲜骨髓抽吸物时，这些检测很有用，因为活检的多个印片可在床边轻松制备。
