Diagnostic Value Of Using Combined Detection Of Bone Marrow Examination Methods For Bone Marrow Involve-ment In Primary Non-hodgkin's Lymphoma

Objective To assess the value of combined bone marrow smear,bone marrow biopsy and bone marrow flow cytometry in detection of invasion of bone marrow in initial treatment of patients with non-Hodgkin's lymphoma(NHL).To analyze the proportion of tissue pathology type of non-hodgkin's lymphoma patients with bone marrow involvement.To evaluate the impact of bone marrow smear,bone marrow biopsy and flow cytometry to clinical stage of non-hodgkin's lymphoma.To determine the diagnostic value of bone marrow examination in patients with unexplained fever.Methods The bone marrow smear,bone marrow biopsy and bone marrow flow cytometry were performed in 96 patients with newly diagnosed NHL from March 2013 to March2016 at the Affiliated Hospital of Qingdao University.The positive rate of the three methods in detection of bone marrow invasion of NHL was compared,and the value of combined detection of the three methods for the disease was evaluated.Statistical analysis was performed using statistical software SPSS17.0.The counting data were analyzed by chi-square test,and the difference was statistically significant with P <0.05.Results The positive rates of bone marrow smear,bon emarrow biopsy,bone marrow flow cytometry and the combination of the three were 19.8%,22.9%,36.5% and 45.8%,re-spectively.The detection rate of bone marrow flow cytometry was significantly higher than that of bone marrow smear or biopsy(?2=7.76,P<0.05).The positive detection rate of combined method was the highest for bone marrow involvement of NHL(?2=19.69,P<0.05).There was no significant difference between bone marrow smear and bone marrow biopsy(?~2 = 0.28,P> 0.05).Bone marrow smear,bone marrow biopsy,flow cytometry were helpful to modify the clinical stage of NHL.The ratio of diffuse large B cell ymphoma involved in bone marrow was the highest among all the sub-types.For some unexplained patients with fever,bone marrow smear,bone marrow biopsy and bone marrow flow cytometry helped to diagnose alone or in combination.Conclusions Combined use of bone marrow smear,bone marrow biopsy and bone marrow flow cytometry is conducive to improvement of positive detection of bone marrow invasion in initial treatment of non-Hodgkin's lymphoma.Its complementary advantages cannot be replaced.The combined use of the three methods contributes to revise the clinical stage,guide the clinical treatment of NHL and assess the prognosis.For some patients with fever of unknown origin,bone marrow examination is helpful for its diagnosis.For a high degree of clinical suspicion of lymphoma bone marrow violations of patients,if the first bone marrow biopsy is negative and can not rule out bone marrow invasion,changing the site again helps to figure out the diagnosis.