同期确诊MDS与AML患者染色体核型分析比较  

Comparison of Chromosome Karyotype Between Myelodysplastic Syndrome and Acute Leukemia Parients Confirmed at the Same Period

作　　者：江明[1] 温丙昭[1] 李玲[1] 陈双[1] 程虹[1] 郝建萍[1] 陈瑢[1] 王蕾[1] 赵芳[1] 

机构地区：[1]新疆医科大学第一附属医院血液病中心、新疆血液病研究所,乌鲁木齐830054

出　　处：《中国实验血液学杂志》2014年第2期387-392,共6页Journal of Experimental Hematology

基　　金：新疆维吾尔自治区自然科学基金项目(201021100A45)

摘　　要：本研究比较分析骨髓增生异常综合征(MDS)及急性髓系白血病(AML)患者的染色体核型异常与诊断、预后的关系,探讨MDS及AML患者不同年龄组染色体预后分层特征。采用骨髓短期培养和R显带技术分析134例MDS和123例AML患者染色体核型。结果表明:MDS与AML患者中染色体异常核型检出率分别为41%及61%。MDS与AML组异常核型分析显示:①MDS组以数目异常为主(主要为+8),AML组患者以结构异常为主,主要为t(15;17)及t(8;21),与FAB亚型相关性不明确的异常核型检出中主要为+8。复杂异常核型检出及预后良好、预后不良核型在MDS组均明显高于AML组;MDS组发生AML转化中有12例为染色体核型异常,AML组有3例染色体核型异常者是由MDS转变而来。②两组行年龄分层分析显示:MDS组随年龄增大异常核型检出率增高,其中在≥60岁组明显高于在≤30岁组,复杂异常核型检出在MDS 3个年龄组未显示有统计学差异;AML组异常核型检出随年龄增大检出率减少,≤30岁组明显高于≥60岁组,而复杂异常核型则显示≥60岁组明显高于≤30岁组;核型预后分析,在MDS与AML组均提示预后不良核型检出率随年龄增长检出率增高,在≥60岁组明显高于在≤30岁组;预后良好核型在MDS及AML则显示≤30岁组又明显高于≥60岁组。结论:MDS及AML患者具有较高的染色体异常,其检测对于诊断、治疗和预后判断具有重要的参考价值;同时染色体核型分析为预后分层提供了重要依据。This study was purposed to compare and analyze the relationship between the abnormality of chromosome karyotypes and diagnosis, prognosis of MDS and AML patients, as well as to explore the characteristics of chromosome prognostic stratification in MDS and AML patients of different ages. The cytogenetic karyotype analysis was performed in 134 cases of MDS and 123 cases of AML by using bone marrow short-term culture and R-banding technigne. The results indicated that the detected rates of charomosome abnormal karyotypes in MDS and AML patients were 41% and 61% respectively. The abnormal karyotype analysis of MDS and AML group showed that the abnormal karyotype in MDS group displayed number abnormality as the dominate （ mainly the ＋ 8 ）, while the abnormal karyotype in AML group displayed structure abnormaliy as the dominant[ mainly, t （ 15 ; 17 ） and t （ 8 ; 21 ） ]. The detected abnormal karyotype are mainly for the ＋ 8 which has ambiguous correlation with FAB subtype; the detection rates of complex karyotype abnormalities,favourahle prognosis karyotype as well as poor prognosis karyotype in the MDS group obviously higher than that of AML group. Among patients with MDS transformed into AML, 12 cases had chromosome abnormal karyotype. There were 3 cases of chromosome abnormal karyotype in AML group which were transformed by MDS. The analysis of age stratification between two groups showed that the detected rate of abnormal karyotype was enhanced with the increase of age in MDS group, and detected rate in ≥60 years old group was obviously higher than that in patients with ≤30 age group. The detected rate of complex karyotype abnormalities in three age groups of MDS did not show statistical difference; the detected rate of abnormal karyotype in AML group decreased with the increase of age, the detected rate in ≤30 years old group was obviously higher than that in ≥60 age group ,while the detection rate of complexkaryotype abnormalities showed that the detected rate in patients ≥ 60 years old

关 键 词：骨髓增生异常综合征 急性髓细胞白血病 染色体 核型异常 预后分析 预后分层 

分 类 号：R733.71[医药卫生—肿瘤] R733.3[医药卫生—临床医学]