【摘要】 目的:探讨骨髓增生异常综合征(myelodysplastic syndrome,MDS)患者胸骨和髂骨骨髓形态学的差异,评价胸骨检查在诊断中的意义。方法:回顾性分析吉林大学第一医院2015年1至12月同时进行胸骨和髂骨检查的21例MDS患者,对比胸骨与髂骨在骨髓增生程度、原始细胞计数、典型病态的差别及对分型诊断的影响。结果:胸骨检查MDS诊断率显著高于髂骨检查;粒细胞系占有核细胞百分比、粒细胞与红细胞比值、伴原始细胞增多(excess blasts,EB)亚型原始细胞计数、红细胞系病态造血细胞比例胸骨均高于髂骨;胸骨检查中具有红细胞系典型病态患者的比例高于髂骨;胸骨穿刺染色体检查成功率高于髂骨穿刺;EB亚型中,胸骨检查国际预后指数评分系统(international prognostic scoring system,IPSS)评分高于髂骨检查。结论:与髂骨相比,胸骨骨髓象检测更易发现典型病态造血及原始细胞增多,在MDS诊断、分型及预后评分、危险分层等方面更加准确。更多还原

【Abstract】 Objective: To investigate the differences of bone marrow morphology between sternum and iliac bone in patients with myelodysplastic syndromes(MDS), and to evaluate the role of sternum examination in the diagnoses of MDS. Methods: Twenty-one patients who underwent sternum and iliac bone marrow aspiration and were diagnosed as MDS in our hospital from January 2015 to December 2015 were retrospectively analyzed. The cellularity, blast counts, typical dysplastic cells between sternum and iliac bone, and the impact on the diagnosis were compared. Results: The diagnostic rate of MDS was significantly higher with sternum examination than that with iliac bone. Myeloid cell percentage, myeloid erythroid ratio, blast percentage of excess blasts(EB) subtype in sternum ilium morphology were higher than those in iliac bone; by sternum examination, patients had more typical dysplastic erythroid cells. The chromosome examination success rate and the international prognostic scoring system(IPSS) score in EB subtype were higher in ilium sternum aspiration than that in iliac bone. Conclusion: Compared with iliac bone, sternal bone marrow aspiration could detect more dysplastic hematopoiesis and increased blasts and it may provide more help for the diagnoses, risk stratification of MDS.更多还原