目的 分析骨髓转移癌的临床特征及实验室检查特点.方法 对以骨髓转移癌为首发表现的29例患者的临床表现及实验室检查结果进行综合分析.结果 骨痛为最常见症状;常见的血象异常包括贫血、血小板减少、外周血涂片出现幼红、幼粒细胞;碱性磷酸酶可异常升高.骨髓细胞学检查均找到数量不等的癌细胞团和(或)单个散落的癌细胞,多见于片尾及边缘.骨髓细胞染色体检查发现非整倍体检出率高,每例细胞染色体数目差异大,同时伴有结构异常.结论 骨髓细胞学检查及骨髓细胞染色体检查在以骨髓转移癌为首发表现患者的诊断和鉴别诊断中有重要意义,出现原因不明的贫血、发热、出血及骨痛,外周血出现幼红、幼粒细胞,碱性磷酸酶及肿瘤标志物升高等,应考虑骨髓转移癌的可能.%Objective To investigate the clinical and experimental features of metastatic carcinoma of bone marrow. Methods Clinical manifestations and laboratory results were analyzed in 29 patients with metastatic carcinoma of bone marrow. Results Osteodynia was one of the most common symptoms. Hematological abnormality including anemia, thrombocyto-penia, erythroblast and immature granulocyte were demonstrated in the peripheral blood smear. Abnormally elevated alkaline phosphatase also can be found. Bone marrow inspection showed the number of cancer cells ranging group and /or single swathes that more common in pane tail and edge. Chromosome inspection showed aneuploid chromosome detection rate is high. Each case the chromosome number were variation and accompanied by structural abnormalities. Conclusion Bone marrow inspection and chromosome inspection were important methods for diagnosis and differential diagnosis of the diseases with metastatic carcinoma of bone marrow. The possibility of metastatic carcinoma of bone marrow should be considered if the symptom including unexplained anemia, fever, hemorrhage and bone pain, erythroblast and immature granulocyte in peripheral blood, elevated ALP and tumor markers.
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