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目的：对神经母细胞瘤（ＮＢ）患儿化疗前后血、骨髓进行系统观察，探索总结ＮＢ细胞髓内转移骨髓动力学变化规律。方法：１４５例ＮＢ患儿均做骨髓与外周血涂片镜检，观察瘤细胞增生程度与形态特点，同时做细胞免疫组化染色。结果：ＮＢ外周血与骨髓像中瘤细胞增生程度及分布因病情而异；瘤细胞所占比例越高，症状越重，化疗后瘤细胞减少，临床症状随之减轻。结论：瘤细胞轻度浸润，镜检可偶见瘤细胞，极易漏诊。中度浸润时，骨髓增生极度低下，瘤细胞少见，易误诊为再障。重度浸润时，瘤细胞占绝对优势，易误诊为各类型白血病。
OBJECTIVE: To systematically observe the blood and bone marrow of patients with neuroblastoma (NB) before and after chemotherapy, and to explore and summarize the changes of bone marrow dynamics in NB cells. Methods: The bone marrow and peripheral blood smears were examined in 145 children with NB. The degree and morphological characteristics of tumor cells were observed, and the cellular immunohistochemical staining was performed at the same time. Results: The degree and distribution of neoplastic cells in NB peripheral blood and bone marrow were different due to the different conditions. The higher the proportion of neoplastic cells was, the more severe the symptoms were. After chemotherapy, the number of neoplastic cells decreased and the clinical symptoms decreased. Conclusion: Mild tumor cells, microscopic examination of tumor cells can be found, easily missed diagnosis. Moderate infiltration, bone marrow hyperplasia is extremely low, rare tumor cells, often misdiagnosed as aplastic anemia. Severe infiltration, the absolute advantage of tumor cells, easily misdiagnosed as various types of leukemia.