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目的:总结多发性骨髓瘤的临床及实验室检查特点,提高多发性骨髓瘤的早期诊断率。方法:回顾性分析21例多发性骨髓瘤患者的临床资料。结果:多发性骨髓瘤患者红细胞、血红蛋白、总蛋白、免疫球蛋白、血沉等多项指标的异常率>50%;骨髓涂片检查示瘤细胞>10%18例;病理切片免疫组织化学检查示CD138阳性率100%;16例骨骼疼痛者行г-骨显像检查,诊断骨折7例,骨代谢活跃8例,溶骨性损害1例。结论:多发性骨髓瘤早期临床表现复杂多样,易误诊和漏诊。血液、尿液等常规筛查,骨髓细胞涂片检查、病理切片免疫组织化学检查及影像学检查,有助于多发性骨髓瘤早期诊断。
OBJECTIVE: To summarize the clinical and laboratory features of multiple myeloma and to improve the early diagnosis rate of multiple myeloma. Methods: The clinical data of 21 patients with multiple myeloma were analyzed retrospectively. Results: The abnormal rates of erythrocyte, hemoglobin, total protein, immunoglobulin, erythrocyte sedimentation rate and other indicators of multiple myeloma were> 50%; bone marrow smear showed tumor cells> 10%; 18 cases were detected by immunohistochemistry CD138 positive rate of 100%; 16 cases of skeletal pain by г-bone imaging examination, diagnosis of fracture in 7 cases, 8 cases of active bone metabolism, osteolytic lesions in 1 case. Conclusion: The early clinical manifestations of multiple myeloma are complex and diverse, and are easily misdiagnosed and missed. Blood, urine and other routine screening, bone marrow smear examination, histological immunohistochemical examination and imaging studies, contribute to the early diagnosis of multiple myeloma.