CBFB-MYH11融合基因与成人急性粒-单核细胞白血病临床特征的相关性分析  

Correlation between CBFB-MYH11 fusion gene and clinical features of adult acute myelomonocytic leukemia

作　　者：赵桂梅 周汶静[1] 王念[1] 郑沁[1] 周娟[1] 周易[1] 叶远馨[1] ZHAO Guimei;ZHOU Wenjing;WANG Nian;ZHENG Qin;ZHOU Juan;ZHOU Yi;YE Yuanxin(Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China;Department of Clinical Laboratory,910th Hospital of the Chinese People′s Liberation Army Joint Logistics Support Force,Quanzhou,Fujian 362000,China)

机构地区：[1]四川大学华西医院实验医学科,四川成都610041 [2]中国人民解放军联勤保障部队第九一○医院检验科,福建泉州362000

出　　处：《国际检验医学杂志》2020年第20期2433-2437,共5页International Journal of Laboratory Medicine

基　　金：国家自然科学基金项目(81101327)。

摘　　要：目的探讨CBFB-MYH11融合基因与成人急性粒-单核细胞白血病(以下简称“急性粒单白血病”)临床特征的相关性。方法选取34例伴CBFB-MYH11阳性的急性粒单白血病患者(阳性组)和89例CBFB-MYH11阴性的急性粒单白血病患者(阴性组)为研究对象,分析比较两组的实验室指标、临床症状、治疗效果,并随访其预后。结果阳性组血小板(PLT)水平显著低于阴性组,而胱抑素C(Cys-C)水平和骨髓粒红比显著高于阴性组,差异均有统计学意义(P<0.05)。阳性组的CD7阳性率为0.0%,阴性组为44.3%,差异有统计学意义(P<0.05);阳性组伴预后基因突变的阳性率为29.4%,阴性组为70.3%,差异有统计学意义(P<0.05)。发热、贫血、出血、肝脾淋巴结肿大、骨痛、牙龈增生均为两组患者发病初期常见的临床症状,阴性组贫血发生率高于阳性组,而肝脾淋巴结肿大发生率低于阳性组,差异均有统计学意义(P<0.05)。阳性组完全缓解(CR)率为78.9%,复发(RLP)率为21.1%,均高于阴性组(45.1%、7.8%),差异均有统计学意义(P<0.05);阴性组部分缓解(PR)率和无缓解(NR)率均为23.5%,阳性组PR率、NR率均为0.0%,两组差异有统计学意义(P<0.05);阳性组达CR的时间显著短于阴性组,差异有统计学意义(P<0.05)。生存分析结果显示,阳性组生存时间长于阴性组,差异有统计学意义(P<0.05);无复发生存期长于阴性组,但差异无统计学意义(P>0.05)。CBFB-MYH11阳性是影响总体生存时间的有利因素,CD56的表达和年龄的增长是不利因素(P<0.05)。结论CBFB-MYH11阳性的成人急性粒单白血病患者的PLT、CD7阳性率、预后基因突变率和贫血发生率较低,而Cys-C和骨髓粒红比较高;且CBFB-MYH11阳性患者对化疗敏感,预后较好,年龄与CD56阳性是预后的不利因素。Objective To investigate the correlation between the fusion gene of CBFB-MYH11 and the clinical characteristics and prognostic factors of acute myelomonocytic leukemia in adults.Methods A total of 34 patients with positive gene of CBFB-MYH11(positive group)and 89 patients with negative gene of CBFB-MYH11(negative group)were selected.The laboratory test indexes,clinical symptoms,treatment effects were retrospectively analyzed and their prognosis were followed up.Results The level of platelet(PLT)of the positive group was significantly lower than the negative group(P<0.05).The Cystatin C(Cys-C)of the positive group was significantly higher than the negative group(P<0.05).The positive rate of CD7 was 0.0%in the positive group and 44.3%in the negative group,differences was statistically significant(P<0.05).The positive rate of prognostic gene mutations in positive group was 29.4%,which of the negative group was 70.3%,differences was statistically significant(P<0.05).Fever,anemia,hemorrhage,swollen of lymph node of liver and spleen,bone pain,gingival hyperplasia were common clinical symptoms in the early stage of the disease in two groups of patients.And rate of anemia in the negative group was significantly higher than that of positive group(P<0.05),while the rate of swollen of lymph node of liver and spleen was significantly lower than that of positive group(P<0.05).The rate of complete remission(CR)in the positive group reached 78.9%,and the recurrence(RLP)rate was 21.1%,which was higher than that in the negative group(P<0.05).Both of the rate of partial remission(PR)and the rate of no remission(NR)in the negative group were 23.5%.The time for complete remission(CR)in the positive group was significantly shorter than that in the negative group,and the difference was statistically significant(P<0.05).The survival analysis showed survival time of positive group was significantly longer than that of the negative group(P<0.05).The progression-free survival period was longer than the negative group,but there was no stat

关 键 词：CBFB-MYH11 急性粒-单核细胞白血病 临床特征 

分 类 号：R446.1[医药卫生—诊断学]