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目的探讨骨髓转移癌患者的骨髓及外周血细胞形态特征及临床特征。方法回顾性分析本院21例确诊的骨髓转移癌患者,分析其骨髓象、外周血象、血液生化指标及临床特点。结果临床上最常见症状为贫血(16/21),其次为骨痛(11/21),再次为发热(5/21),然后为出血(3/21)和消瘦(2/21)。外周血涂片中,3例同时见到幼粒细胞和幼红细胞,4例仅见幼粒细胞,3例仅见幼红细胞。21例患者骨髓象中均可找到单个或成团、成簇出现的转移癌细胞。明确肿瘤原发灶者依次为肺癌5例、胃癌4例、乳腺癌2例、前列腺癌2例、肝癌2例、结直肠癌及鼻咽癌各1例,分布不明者4例。结论出现原因不明的贫血、发热、出血及骨痛且周围血中出现幼红、幼粒细胞时,应考虑骨髓转移癌的可能。骨髓穿刺是简单而有效的确诊手段。
Objective To investigate the morphological and clinical features of bone marrow and peripheral blood cells in patients with bone marrow metastasis. Methods A retrospective analysis of 21 patients with bone marrow metastases confirmed in our hospital, analysis of bone marrow, peripheral blood, blood biochemical indicators and clinical features. Results The most common clinical symptoms were anemia (16/21), followed by bone pain (11/21), fever again (5/21), then bleeding (3/21) and weight loss (2/21). In the peripheral blood smear, 3 cases showed both myeloblasts and erythrocytes, 4 myeloma cells and 3 erythrocytes. 21 patients with bone marrow can be found in single or in groups, clusters of metastatic cancer cells. 5 cases of lung cancer, 4 cases of gastric cancer, 2 cases of breast cancer, 2 cases of prostate cancer, 2 cases of liver cancer, 1 case of colorectal cancer and nasopharyngeal carcinoma, and 4 cases of unknown distribution. Conclusions In patients with unexplained anemia, fever, hemorrhage, and bone pain and the presence of erythroid and promyelocytic cells in the peripheral blood, the possibility of metastasis to the bone marrow should be considered. Bone marrow aspiration is a simple and effective diagnostic tool.