Application Of Bone Marrow Smear Combined With Bone Marrow Biopsy,immunophenotyping And Cytogenetics In The Diagnosis Of MDs

Objective:To analyze the characteristics of patients with MDS,and to compare the diagnostic compliance rates of the four detection methods for single,double,triple and quadruple use for MDS,and to provide ideas for clinicians to improve the diagnosis rate of MDS.Methods:Eighty-one patients with MDS who were newly diagnosed in the Gansu Provincial Hospital and met the inclusion and exclusion criteria were screened.Clinical data such as age,gender,clinical manifestations,blood routine,bone marrow smear,bone marrow biopsy,immunophenotyping and cytogenetics were collected.The clinical features of patients with MDS were retrospectively analyzed.The diagnostic compliance rates of MDS were compared between the four detection methods,single,two,three and four.Part of the data was processed using SPSS 21.0,P < 0.05 for the difference was statistically significant.Results: 1.Of the 81 patients with MDS,39 were male and 42 were female.The age ranged from 16 to 80 years old,with a median age of 60 years.The highest number of patients was in the 60-70 age group,accounting for 32.50%.2.The most common clinical manifestations of 81 patients with MDS were symptoms of anemia such as dizziness and fatigue.All the 75 patients had symptoms of dizziness and fatigue(92.60%).There were different degrees of hematocytopenia,with the largest decrease in the three lines,a total of 59 cases.The proportion is 72.84%.3.Bone marrow smear showed pathological hematopoiesis in the second and third line,34 cases(41.98%)and 27 cases(33.33%).In bone marrow biopsy,23 patients had abnormal localization of immature precursors(28.40%),9 patients with myelofibrosis(11.11%),56 cases(69.14%)had abnormal immunophenotype,38 cases(46.91%)had abnormal karyotype,and 16 cases(19.75%)had complex karyotype.The most common abnormal chromosomes were : +8,-Y,5q—,-7,20q—.4.Twelve patients were converted to acute myeloid leukemia(14.81%),with M2 being the most common and 7 cases(58.33%),Among them,9 cases were abnormal karyotypes(accounting for 23.68% of abnormal cases).5.Single bone marrow smear,double(bone marrow smear + bone marrow biopsy),triple(bone marrow smear + bone marrow biopsy + immunophenotyping),quadruple(bone marrow smear + bone marrow biopsy + immunophenotype + cytogenetics)The diagnostic compliance rates of MDS were 48.15%,64.20%,79.01%,and 91.36%.Conclusion: 1.Bone marrow biopsy is superior to bone marrow smears in assessing the degree of myeloproliferative,myelofibrosis and bone marrow hematopoietic tissue.2.Patients with abnormal karyotypes in MDS have a higher probability of conversion to acute myeloid leukemia than normal patients.3.Bone marrow smear,bone marrow biopsy,immunophenotyping,cytogenetics have their own advantages and disadvantages,can make up for each other’s deficiencies,combined use can improve the diagnostic rate of MDS.