The Clinical Value of Bone Marrow Smear Morphology in the Diagnosis of Bone Marrow Involvement in Patients with NHL
Objective To investigate the clinical value of bone marrow smear morphology in the diagnosis of bone marrow involvement in patients with NHL.Methods Clinical data of 318 patients with NHL were collected during the period from January 2013 to January 2020.All selected patients underwent bone marrow biopsy and morphological examination of bone marrow smear and the clinical efficacy of bone marrow smear morphology in the diagnosis of bone marrow involvement in NHL were evaluated.Results Among 318 patients,56 cases of bone marrow invasion were diagnosed by bone marrow smear morphologic examination and bone marrow biopsy,while 210 cases were not found.The consistency rate of the two methods was 83.65％(266/318),and Kappa index of the two methods was 0.583,with 95％CI of 0.487-0.679(P＜0.05).The sensitivity,specificity,positive predictive value and negative predictive value of bone marrow involvement were 53.85％(56/104),98.13％(210/214),93.33％(56/60)and 81.40％(210/258),respectively.With these results,inconsistencies were detected,i.e.positive bone marrow biopsy but with negative bone marrow smear morphology,including 8 cases of PTCL-NOS,12 cases of FL,20 cases of DLBCL,4 cases of AITL,2 cases of MCL,and 2 cases of mucosa-associated lymphoma.The diagnostic sensitivity,specificity,positive predictive value and negative predictive value of bone marrow smear morphological examination for patients with indolent NHL were 73.68％(28/38),92.00％(46/50),87.50％(28/32)and 82.14％(46/56),respectively.The diagnostic sensitivity,specificity,positive predictive value and negative predictive value of bone marrow smear for invasive NHL patients were 42.42％(28/66),100.00％(164/164),100.00％(28/28),and 81.19％(164/202),respectively.Conclusion Bone marrow smear morphologic examination is useful in the diagnosis of NHL bone marrow involvement,and can serve as a reference and supplement for bone marrow biopsy.
NETL
NSTL
万方数据
维普
