The Value of Bone Marrow Morphology in the Diagnosis of Prefibrotic Primary Myelofibrosis and Essential Thrombocythemia
Objective To investigate the value of pathological features,clinical features and gene mutation of megakaryocytes in the differential diagnosis of prefibrotic primary myelofibrosis(pre-PMF)and essential throm-bocythemia(ET).Methods From January 2010 to December 2020,68 newly diagnosed PMF and ET patients were collected from the hematology department of our hospital.According to the diagnostic criteria of the World Health Organization(WHO)for myeloproliferative neoplasm(MPN)in 2016,the bone marrow biopsy sections of patients were reevaluated,and the results of laboratory examination,clinical signs,diagnostic classification and gene mutation detection were collected for statistical analysis.Results After reclassification according to the updated diagnostic criteria,there were 23 cases of ET and 45 cases of PMF,including 22 cases of pre-PMF(49％of PMF)and 23 cases of overt-PMF(51％of PMF).Thirty-five patients(51％)were male,and 33(49％)were female.24 patients(35％)were aged ≥ 65 years,35 patients(51％)with Leukocytosis,17 patients(25％)with anemia,10 patients(15％)with thrombocytopenia,and 25 patients(37％)with splenomegaly.The percent-age of type Ⅰ,Ⅱ,Ⅲ and type V megakaryocytes in pre-PMF group was significantly higher than that in ET group(P all＜0.01).The percentage of type Ⅳ megakaryocytes in ET group was higher than that in pre-PMF group(P＜0.01).In ET,pre-PMF and overt-PMF groups,there was no significant difference in the mutations of JAK2V617F,CALR and MPL(P＞0.05).Conclusion The pathological changes and fibrosis characteristics of bone marrow megakaryocytes in patients with ET and pre-PMF were different.Combined with the mutations of JAK2V617F,CALR and MPL,it could have great value for differential diagnosis of pre-PMF and ET.
万方数据
维普
