| Objective: Through the comparative observation of bone marrow smears and bone marrow biopsy results,the significance of both for bone marrow metastases was further clarified.Methods:A total of 102 patients diagnosed as bone marrow metastases from the Department of Hematology of the First Affiliated Hospital of Hebei North College between January 2012 and May 2017 were collected.All patients were simultaneously examined by bone marrow biopsy and bone marrow biopsy.The bone marrow smears were stained with conventional Wright-Giemsa,bone marrow biopsy specimens were stained with HE and reticular fiber silver for pathological diagnosis.Immunohistochemical staining was used to detect the expression of 12 antigens.Results:1.102 patients have been diagnosed with bone marrow metastases,including 43 females and 59 males.The age of onset was 6 to 82 years and the median age was 44 years.The initial clinical manifestations of 102 patients were anemia in 80 cases(78%),bone pain in 73 cases(72%),thrombocytopenia in 62 cases(61%),and neutropenia in 52 cases(51%).2.In 102 patients,100 cases of metastatic tumor cells were detected in bone marrow smear and biopsy.Among 92 biopsy sections,cancer cells can be found.78 cancer cells can be found in the smears,and positive smear results were negative in 8 patients.Two cases of bone marrow smears and biopsy did not find metastatic tumor cells,and other bone marrow metastases were confirmed by other examination results and clinical manifestations.The detection of metastatic tumor cells by bone marrow smears and biopsies was statistically different(X2=6.198,P<0.05).3.Through bone marrow smear,it was found that 91 cases of bone marrow hyperplasia were active,and the bone marrow hyperplasia was found to be active and above 93 cases by bone marrow biopsy.Bone marrow smears showed an increase in the number of red blood cells and normal in 91 cases,reduced in 11 cases;granulocyte count increased and normal in 90 cases,reduced in 12 cases.Bone marrow biopsy showed an increase in the number of red blood cells and normal 92 cases,reduced by 10 cases.The number of granulocytes increased and normal in 93 cases,reduced in 9 cases.4.92 cases of biopsy confirmed gastric cancer(24 cases),immunohistochemical results showed CK+,CK20+,Villin+.Colon cancer(19 cases),CK+,CK20+.Breast cancer(18 cases),CK+,ER+,PR+.Prostate cancer(17 cases)CK+,PSA+.Lung cancer(7 cases),immunohistochemical results showed CK+,TTF-1+.Small cell carcinoma(4 cases),immunohistochemical results showed CK+,Cg A+,Syn+.Neuroblastoma(2 cases),immunohistochemistry results showed Cg A+,Syn +.Kaposi’s sarcoma(1 case),immunohistochemistry results for CD34 +,Vim +.Conclusions:1.The positive detection rate of bone marrow biopsy for bone marrow metastases is higher than that of bone marrow smears.The bone marrow smear test has significance for the diagnosis of bone marrow biopsy-negative patients.2.When observing cell morphology,bone marrow smears have more advantages,and bone marrow biopsy has advantages in observing bone marrow hyperplasia,histomorphology,and pathological diagnosis.3.The bone marrow biopsy combined with immunohistochemistry can further clarify the source of metastatic tumor cells.Bone marrow biopsy combined with bone marrow smear can improve the understanding of the morphological characteristics of various metastatic tumor cells and reduce missed diagnosis. |
