The diagnostic significance of bone marrow smear combined with bone marrow biopsy in pancytopenia / 中国医师进修杂志

ABSTRACT

Objective To investigate the diagnostic significance of bone marrow smear combined with bone marrow biopsy in pancytopenia.Methods The clinical data of 94 pancytopenia patients who were detected by bone marrow smear and bone marrow biopsy synchronously were retrospectively analyzed.Results In 94 pancytopenia patients,leukemia was in 29 cases (30.85％),myelodysplastic syndrome (MDS)was in 20 cases (21.28％),aplastic anemia (AA) was in 18 cases (19.15％),multiple myeloma (MM) was in 4 cases (4.26％),primary myelofibrosis (MF) was in 2 cases (2.13％),metastatic cancer was in 3 cases (3.19％),lymphoma in bone marrow infiltration was in 3 cases (3.19％),megaloblastic anemia (MA) was in 10 cases (10.64％),and iron deficiency anemia (IDA) was in 5 cases (5.32％).In 29 leukemia patients,acute myeloid leukemia-M2 (AML-M2) was in 5 cases,acute myeloid leukemia-M3 (AML-M3) was in 9 cases,acute myeloid leukemia-M5 (AML-M55) was in 6 cases,acute myeloid leukemia-M4 (AML-M4) was in 2 cases,acute lymphoblastic leukemia (ALL) was in 3 cases,chronic lymphocytic leukemia (CLL) was in 3 cases,and hairy cell leukemia was in 1 case.The diagnostic accuracy of bone marrow smear was 88.30％ (83/94),the diagnostic accuracy of bone marrow biopsy was 92.55％ (87/94),and the diagnostic accuracy of bone marrow smear combined with bone marrow biopsy was 98.94％ (93/94).The diagnostic accuracy of bone marrow biopsy was higher than that of bone marrow smear,but there was no statistical difference (x2 =0.89,P ＞ 0.05).The diagnostic accuracy of bone marrow smear combined with bone marrow biopsy was higher than that of bone marrow smear,and there was statistical difference (x2 =8.70,P ＜ 0.01).There was no statistical difference in the misdiagnosis rate between bone marrow smear and bone marrow biopsy11.70％ (11/94) vs.7.45％(7/94),x2 =0.89,P ＞ 0.05.Conclusions The bone marrow smear combined with the bone marrow biopsy can improve the diagnostic accuracy of the blood system diseases,especially in pancytopenia,and has a very important diagnostic significance.It should be included in routine testing project.