COMPARISON OF DIAGNOSTIC ACCURACY OF BONE MARROW ASPIRATE AND TREPHINE BIOPSY PROCEDURE

Objective: The objective of this study was to compare the diagnostic accuracy of bone marrow aspirate and trephine biopsy procedure. Methodology: This cross sectional study was carried out for twelve months in Department of Haematology and Transfusion Medicine, of the Nawaz Sharif Social Security Hospital, Multan Road Lahore. Total 100 subjects with haematological indication for the bone marrow aspirate and trephine biopsy procedure for all ages were included in the study. According to inclusion criteria selected patients were subjected to bone marrow biopsy procedure in bone marrow biopsy room of the Haematology Department of the same hospital. Bone marrow aspirates and trephine biopsies were taken from posterior iliac crest under fully aseptic technique and local anesthesia. Bone marrow aspi- rate slides were made and after fixation in ethanol, they were stained with Giemsa stain and observed under microscope for results. The trephine biopsy sections were examined microscopically and results were recorded according to findings. Results: The mean age of patients was 40.46 +/- 19.20 years and age range 1 year to 84 years. Keeping Bone Marrow Trephine Biopsy as gold standard, the sensitivity of Bone Marrow Aspirate was 67.09% and specificity was 38.1%. While, the positive predictive value was 80.3% and negative predictive value was 23.53%. The overall diagnostic accuracy of Bone Marrow Aspirate, keeping Trephine Biopsy as gold standard was 61%. Conclusion: Bone Marrow Trephine Biopsy has higher diagnostic accuracy and is more reliable and sensitive procedure compared to Aspirate. Therefore it should be a mandatory procedure along with bone marrow aspirate for patients seeking diagnosis through bone marrow examination.