论文部分内容阅读
目的:骨髓瘤细胞形态呈多样性,圆形或椭圆形细胞核形态的丧失和人类恶性细胞相关,观察多发性骨髓瘤骨髓涂片浆细胞核形的改变,研究浆细胞核形态异常的临床意义。方法:采用回顾性研究的方法总结了自2000～2007年诊断为多发性骨髓瘤的患者120例,全部诊断按照张之南、沈悌主编的《血液病诊断及疗效标准》第3版重新评估,骨髓涂片进行形态学检查,结合分型、分期、血β2-微球蛋白(β2-MG)、白蛋白、治疗疗效等指标。结果:经卡方及t检验,在观察120例骨髓涂片中约51.0%的患者出现浆细胞核形态异常,与分型关系不大,分期多为Ⅲ期,血清β2-MG增高,白蛋白下降,治疗反应差,疾病进展。结论:核形态异常与分型关系不大,与疾病预后指标,如β2-MG、白蛋白相关,与疾病病期相关,Ⅲ期患者多见,常规治疗效果差。
OBJECTIVE: The morphology of myeloma cells is diverse. The loss of round or oval nucleus morphology is associated with human malignant cells. To observe the changes of plasma cell nuclear shape in multiple myeloma bone marrow smears and to study the clinical significance of plasma cell nuclear morphological abnormalities. Methods: A retrospective study was conducted to summarize 120 patients diagnosed with multiple myeloma from 2000 to 2007. All diagnoses were re-evaluated according to the third edition of “Standard of Diagnostic and Efficacy of Hematology” edited by Zhang Zhinan and Shen Yong. The bone marrow Smear morphological examination, combined with typing, staging, serum β2-microglobulin (β2-MG), albumin, therapeutic efficacy and other indicators. Results: By chi-square test and t-test, about 51.0% of the 120 bone marrow smears were found to have abnormal plasma nuclei. There was no significant correlation with the subtype, stage Ⅲ mostly, serum β2-MG increased and albumin decreased , Poor response to treatment, disease progression. CONCLUSIONS: Nuclear morphological abnormalities have little to do with the subtypes, and are associated with disease prognostic indicators such as β2-MG and albumin. They are associated with the disease stage. Patients with stage Ⅲ are more common and the conventional treatment is poor.