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目的 :应用形态学、免疫学、细胞遗传学和分子生物学 (MICM)分型联合检测 t(8;2 1)急性髓细胞性白血病(AML ) ,以提高 t(8;2 1) AML的临床检出率和诊断准确率。方法 :以 4 5例 AML的初诊患者为研究对象 ,分别采用传统的骨髓细胞形态学观察和细胞化学染色进行 FAB分型 ;流式细胞术 (FCM)检测白血病细胞免疫表型 ;骨髓细胞短期培养法常规制备染色体标本 ,RHG显带技术进行核型分析 ;巢式 RT- PCR检测 AML 1- ETO融合转录本。结果 :4 7.1%以上的 t(8;2 1) AML患者有特征性的形态学改变 ,10 0 %的患者 93%以上的白血病细胞 MPO染色呈强阳性 ,t(8;2 1) AML主要见于 FAB- M2 ,但也可见于其他亚型 ;80 %的 t(8;2 1) AML患者伴有常规细胞遗传学可检测到的 t(8;2 1)易位 ;10 0 %的 t(8;2 1) AML患者 AML 1- ETO融合基因阳性 ;t(8;2 1) + 组 CD1 9、CD34 的表达及 CD1 9、CD34 的共表达率明显高于 t(8;2 1) - 组。结论 :t(8;2 1) AML 具有特征性的形态学、细胞遗传学、免疫学和分子生物学改变 ;应用 MICM分型联合检测 t(8;2 1) AML,能提高 t(8;2 1) AML 的检出率和诊断准确率 ,其中 ,采用巢式 RT-PCR检测 AML1- ETO融合转录本在 MICM分型中占有十分重要的地位
OBJECTIVE: To detect t(8;21) acute myeloid leukemia (AML) using morphology, immunology, cytogenetics, and molecular biology (MICM) typing to improve t(8;21) AML Clinical detection rate and diagnostic accuracy. Methods: Forty-five newly diagnosed patients with AML were studied. FAB classification was performed using traditional bone marrow cell morphology and cytochemical staining. The immunophenotype of leukemia cells was detected by flow cytometry (FCM); short-term culture of bone marrow cells was performed. The routine preparation of chromosome samples, RHG banding technique for karyotype analysis; nested RT-PCR detection of AML 1-ETO fusion transcripts. RESULTS: More than 7.1% of patients with t(8;21) AML had characteristic morphological changes, and more than 93% of patients with leukemia showed strong positive staining for MPO, and t(8;21) AML mainly Found in FAB-M2, but also in other subtypes; 80% of patients with t(8;21) AML were associated with a routine cytogenetically detectable t(8;21) translocation; 10% of t (8;2 1) AML 1-ETO fusion gene was positive in AML patients; expression of CD19 and CD34 in CD8 and CD34 was significantly higher in t(8;21)+ group than in t(8;21). - Group. CONCLUSION: t(8;21) AML has characteristic morphological, cytogenetic, immunological, and molecular biological changes. The combined use of MICM typing to detect t(8;21) AML can increase t(8; 2 1) Detection rate and diagnostic accuracy of AML, among which, detection of AML1-ETO fusion transcript using nested RT-PCR occupies a very important position in MICM typing.