MDS-RAMgA与M6骨髓细胞形态学鉴别诊断.docVIP

MDS-RAMgA与M6骨髓细胞形态学鉴别诊断 　　[摘要] 目的：分析MDS-RA、MgA及M6患者骨髓细胞形态特点，以提高对相关疾病的认识。方法: 对在我院及上海瑞金医院确诊的25例MDS-RA，MgA及M6患者的骨髓细胞形态进行分析。结果：MDS-RA骨髓增生活跃或明显活跃，偶见增生减低，粒红比常减低，常见两系以上病态；MgA骨髓增生明显活跃，粒红比常减低，粒红两系出现巨幼样变；M6骨髓增生明显活跃，粒红比常倒置，红系明显病态，原始细胞增多。结论：MDS-RA，MgA及M6的骨髓象共同点：都会出现红系明显增生，出现巨幼样病态改变。不同点：MDS-RA与M6主要是各系病态造血明显，通常以原始细胞比例不同进行鉴别，而MgA主要表现为各系的巨幼样变,且原始细胞比例不高。 　　[关键词] 骨髓异常增生综合征难治性贫血(MDS-RA) 巨幼细胞性贫血(MgA) 急性红白血病(M6) 　　[中图分类号] R446.1[文献标识码] B [文章编号] 1673-7210（2011）02（c）-073-02 　　Differential diagnostic of bone marrow morphocytology in the patients with MDS-RA, MgA and M6 　　YU Yuanjun1, ZHANG Min2 　　（1.Department of Labs, the Third Peoples Hospital of Dalian, Liaoning Province, Dalian116033, China; 2.Affiliated Reijin Hospital of Shanghai Communication University, Shanghai200025, China ) 　　[Abstact] Objective: To analyze the bone marrow morphocytology in the patients with MDS-RA, MgA and M6, deepen our understanding of related diseases. Methods: 25 cases diagnosed in our hospital and Shanghai Ruijin Hospital were analyzed. Results: MDS-RA of the bone marrow showed active or significantly active proliferation, occasionally showed hypoplasia.The ratio of G/E in bone marrow often reduced and more than two series were dysplastic. MgA of the bone marrow showed significantly active proliferation. The ratio of G/E in bone marrow often reduced and the bone marrow cells had a change of giants. M6 of the bone marrow showed significantly active proliferation. The ratio of G/E in bone marrow were often inverse. Erythrocytes were significantly dysplastic and the more ratio of blastocytes was found. Conclusion: MDS-RA, MgA and M6 of the bone marrow showed in common that erythrocytes were significantly active proliferation and the bone marrow cells had a change of giants. The differentia shows that the bone marrow of MDS-RA and M6 are dysplastic and have the different ratio of blastocytes. The bone marrow cells of MgA have a change of giants and the ratio of blastocytes is not high. 　　[Key words] M