非霍奇金淋巴瘤的临床与骨髓细胞遗传学分析

Analysis of the non-Hodgkin lymphoma's clinic and blood marrow cytogenetics

目的研究非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL)的细胞遗传学、血液病理学、血液形态学、临床肿瘤指标与预后的相互关系。方法应用骨髓直接法和24h短期培养法制备染色体标本,用R显带技术,对20例NHL患者进行核型分析。所有患者均进行血清P53蛋白检测。结果20例NHL中出现骨髓浸润8例。20例NHL中,发现有异常核型9例,发生率45%(9/20)。异常类型包括:染色体数目异常3例,t(14,18)(q32;q21)1例,14q+1例,t(8;14)(q24;q32)2例,t(8;14)(q24;q32)伴其他异常2例。伴异常核型的患者其血清P53蛋白含量显著高于正常核型者。结论t(8;14)(q24;q32)是NHL中涉及较多的染色体核型异常,伴此种核型异常的NHL患者预后不良,同时发现正常核型缺乏对预后也有不良影响。突变型P53值的增高和染色体核型异常有一定的相关性,也是预后不良的因素。

Objective To analyze the relationship among cytogenetics, hematopathology, morphology, clinic tumor index and prognosis of the non-Hodgkin lymphoma（NHL） patients. Methods Cytogenetics analysis of bone marrow cells was performed by direct method and 24 h culture method in 20 cases of NHL. Serous P53 protein was detected in all patients. Results Out of the twenty NHL patients, eight had bone marrow infiltration, and nine were found with abnormal karyotype： three were chromosome number abnormalities, one was t（ 14,18） （q32; q21 ）, one was 14q ＋ , two were t 18; 14）（q24;q32）, two were t（8; 14）（q24;q32） with additional changes of chromosome. The serous P53 protein of patients with abnormal karyotype was significantly higher than that with normal karyotype. Conclusion t （8;14） （q24; q32） is the most classic translocation in NHL, The patients with this karyotype have worse prognosis. The increase of mutant serous P53 relates to abnormal karyotype, and the patients with high mutant P53 level in serum also have worse prognosis.