河南豫北地区196例成人急性髓系白血病临床病理特征分析  

Clinical and pathological characteristics analysis of 196 adult acute myeloid leukemia in the northern Henan province

作　　者：杨翠[1] 李敬东[1] 字友梅[1] 高攀科 韩效林[1] YANG Cui;LI Jingdong;ZI Youmei;GAO Panke;HAN Xiaolin(Department of Hematology,the First Affiliated Hospital of Xinxiang Medical College,Weihui 453100,China)

机构地区：[1]新乡医学院第一附属医院血液科,河南卫辉453100

出　　处：《肿瘤基础与临床》2020年第2期139-143,共5页journal of basic and clinical oncology

基　　金：河南省医学科技攻关项目(编号:201602152)。

摘　　要：目的分析河南豫北地区成人急性髓系白血病(AML)患者的临床病理特征。方法回顾性分析我院2013年1月至2018年12月收治的196例河南豫北地区初诊AML患者的临床病理资料,根据患者年龄分为老年组(≥60岁,75例)、青年组(<60岁,121例)。比较2组患者外周血中红细胞、血红蛋白、血小板、白细胞,骨髓原细胞比例,FAB分型结果。采用聚合酶链反应检测AML患者的43种融合基因,比较观察2组融合基因表达差异;采用基因测序的方法检测2组患者5种常见基因突变的发生情况,比较观察2组患者基因突变的差异。结果老年组患者外周血红细胞、血红蛋白及血小板水平均较青年组患者显著下降(P均<0.05);2组患者外周血白细胞和骨髓原始细胞比例比较差异均无统计学意义(P均>005)。FAB分型显示老年组患者以M2型为主,青年组患者以M3型为主,差异均有统计学意义(P均<0.05)。2组患者各种融合基因检测结果比较差异均无统计学意义(P均>0.05)。196例患者5种基因突变总检出率为37.2%。老年组患者脱氧核糖核酸甲基转移酶3A(DNMT3A)突变发生率高于青年组患者,差异有统计学意义(P<0.05);2组患者FMS样酪氨酸激酶3-内部串联重复、核仁磷酸蛋白1、CCAAT/增强结合蛋白A、C-KIT突变率比较差异均无统计学意义(P均>0.05)。老年组患者发生2种及以上基因突变的比例高于青年组患者,差异有统计学意义(P<0.05)。结论老年和青年初诊AML患者临床病理特征存在一定差异。与青年患者比较,老年患者外周血血红蛋白、红细胞数目、血小板水平较低,DNMT3A突变率较高,且易出现多基因突变。Objective To analyze the clinical and pathological characteristics of adult acute myeloid leukemia in northern Henan province.Methods The clinical data of 196 patients with primary AML in northern Henan province treated in our hospital from January 2013 to December 2018 were retrospectively analyzed.According to the age of the patients were divided into two groups:the elderly group(≥60 years old,75 patients)and the young group(<60 years old,121 patients).The peripheral blood red blood cells,peripheral blood hemoglobin,peripheral blood platelets,peripheral blood white blood cells,bone marrow progenitor cell proportion and FAB typing were compared in the two groups.Polymerase chain reaction was used to detect 43 fusion genes between the AML patients and the fusion genes were compared in the two groups.Gene sequencing was used to detect the occurrence of 5 common gene mutations in the two groups,and the differences of gene mutations in the two groups were observed.Results Compared with the youth group,the levels of hemoglobin,red blood cell and platelet(PLT)were significantly decreased in the elderly group(P<0.05).There was no significant difference in the peripheral blood white blood cell count and bone marrow progenitor cell ratio between the two groups(P>0.05).According to FAB classification,the elderly group patients were mainly M2 type and the youth group patients were mainly M3 type,the difference was statistically significant(P<0.05).There was no significant difference in the results of fusion genes between the two groups(P>0.05).The positive rate of five gene mutations was 37.2%in the 196 patients.The incidence of deoxyribonucleic acid methytransferase 3A(DNMT3A)mutation in the elderly group was higher than that in the youth group,and the difference was statistically significant(P<0.05).There was no statistical difference in the incidences of fms-like tyrosine kinase 3-internal tandem duplication,nucleophosmin gene 1,CCAAT/enhancer binding protein A and C-KIT mutations between the two groups(P>0.05).In the

关 键 词：急性髓系白血病 年龄 基因突变 

分 类 号：R733.71[医药卫生—肿瘤]