论文部分内容阅读
目的:探讨急性髓细胞白血病(AML)染色体异常核型的分布情况、特点及其与预后的关系。方法:选择2009年1月~2012年12月在本院门诊和住院治疗的AML患者277例,采取新鲜骨髓,采用直接法和短期培养制备标本,以R显带技术进行染色体核型分析。结果:除47例无分裂相共检出异常核型122例,异常率为53.04%。结构异常(75例)以t(15;17)(56例)和t(8;21)(19例)常见,1.78%的M2、90.77%的M3、26.79%的M2和1.85%的M5分别有t(7;11)、t(15;17)、t(8;21)和t(11q23)异常,而100%的t(7;11)、100%的t(15;17)、55.56%的t(8;21)、100%的t(8;15)和66.7%的t(11q23)分别见于M2、M3、M2、M5和M4亚型。数目异常(28例)以+8(12例)为常见,100%的+22见于M4E0。结构和数目同时异常(19例)以t(8;21)伴性染色体丢失(8例)为最常见,100%为M2。核型异常与临床缓解率高度相关,伴t(15;17)易位组、伴t(8;21)易位组预后佳,正常核型组次之,其它异常核型预后较差,复杂核型预后最差。结论:特定的染色体异常与亚型及预后密切相关,染色体核型分析在急性髓细胞白血病诊断、分型、治疗及预后判断中具有十分重要的地位和作用。
Objective: To investigate the distribution and characteristics of chromosomal abnormal karyotypes in acute myeloid leukemia (AML) and its relationship with prognosis. Methods: A total of 277 AML patients were selected from our hospital and inpatient hospital from January 2009 to December 2012. Fresh bone marrow was collected. The specimens were prepared by direct method and short-term culture. The karyotypes were analyzed by R-banding technique. Results: There were 122 cases of abnormal karyotype detected in 47 cases without schizonts, the abnormal rate was 53.04%. Structural abnormalities (75 cases) were common in t (15; 17) (56 cases) and t (8; 21) (19 cases) with 1.78% of M2, 90.77% of M3, 26.79% of M2 and 1.85% of M5 (7; 11), t (15; 17), t (8; 21) and t (11q23) The percent t (8; 21), 100% t (8; 15) and 66.7% t (11q23) are found in the M2, M3, M2, M5 and M4 subtypes, respectively. The number of abnormalities (n = 28) was common in +8 (n = 12) and in M4E0 at + 100%. Abnormalities in both structure and number (n = 19) were most common with t (8; 21) chromosome loss (n = 8), with 100% being M2. The karyotype abnormality was highly correlated with the clinical remission rate. The prognosis was good with t (15; 17) translocation group and t (8; 21) translocation group, followed by normal karyotype group. Other abnormal karyotypes had poor prognosis and complicated Karyotype prognosis is the worst. Conclusion: Specific chromosomal abnormalities are closely related to subtypes and prognosis. Chromosome karyotype analysis plays an important role in the diagnosis, classification, treatment and prognosis of acute myeloid leukemia.