【作者】 陈新颖；

【导师】 蔡正文；

【作者基本信息】 广西医科大学 ， 肿瘤学， 2012， 硕士

【摘要】 目的：探讨骨髓转移癌患者的临床表现和实验室检查特点,为临床上更好地诊断和治疗骨髓转移癌提供理论依据。方法：回顾性分析40例骨髓转移癌患者的临床表现、骨髓细胞学、骨髓病理学及免疫组化和器械检查的特点。结果：骨痛、发热、消瘦等为最常见的症状;常见的血象异常包括贫血、血小板减少,外周血可出现幼红细胞、幼粒细胞;骨髓细胞学：增生度大部分患者呈增生减低,34例患者可检出转移癌细胞;骨髓活检病理形态学有11例患者检出癌细胞,免疫组化中Ki-67、Bcl-2、P21部分病例呈阳性表达;有36例患者骨ECT扫描发现骨放射性异常,有21例患者骨核磁共振成像发现异常信号影。结论：临床出现骨痛、发热、消瘦伴血象异常,尤其是出现幼红、幼粒细胞血症时应该考虑是否有骨髓转移癌。骨髓穿刺足简单而有效的确诊手段,有时需重复多次/多部位骨穿,结合骨髓活检可提高骨髓转移癌的检出率。骨髓活检病理免疫组化指标Ki-67、Bcl-2、P21等对恶性肿瘤,尤其是伴有骨髓转移癌患者的预后判断有一定的价值。更多还原

【Abstract】 Objective:to explore the clinical and laboratory characteristics of bone marrow metastatic carcinoma patients,better for clinical diagnosis and treatment of bone marrow metastatic carcinoma to provide the theory basis.Methods:40cases bone marrow were retrospectively analyzed the clinical manifestations of patients with metastatic carcinoma, bone marrow cell biology, bone marrow pathology and immunohistochemical and equipment checkfeatures.Results:bone pain, fever, emaciation are the most common symptom; common blood picture abnormalities include anemia, thrombocytopenia, peripheral blood can appear red blood cells called young young; bone marrow cytology hyperplasia degrees, most patients reduce hyperplasia,34patients can be detected transfer cancer cells;bone marrow morphology by pathology in11patients detected the cancer cells, in immunohistochemical Ki-67, Bcl-2, P21part cases positive expression;36cases of patients ECT bone scan found bone radioactive anomalies21patients bone nuclear magnetic resonance (MRI) imaging of abnonnal signals.Conclusion:clinical pain, fever, appear bone with abnonnal blood picture appear especially thin young red young granulocyte should be considered when whether bone marrow metastatic carcinoma, bone marrow targeted was simple and effective means of diagnosis,sometimes should be repeated many times more bone wear parts, combined with bone marrow biopsy can improve the transfer of bone marrow cancer detection rate, bone marrow by pathology immunohistochemical index Ki-67, Bc1-2, P21of malignant tumor,especially associated with bone marrow transfer carcinoma of the prognostic have a certain value.更多还原