慢性粒细胞白血病的染色体核型及其预后意义

The Karyotype Analysis and Prognosis in Patients with Chronic Granulocytic Leukemia

目的分析细胞遗传学在慢性粒细胞白血病(CGL)的诊断、疗效及其预后中的临床意义。方法对131例采用骨髓细胞直接法和(或)短期(24h)培养法制备染色体标本,采用R显带技术进行核型分析。结果在131例CGL中,发现121例Ph(+),在病程各期(急性期、加速期、急变期)均出现,占92.4%,10例Ph(-),占7.6%。121例Ph(+)者,其中102例Ph(+)细胞为100%,占84.3%,19例Ph(+)细胞为45%-96%,占15.7%。27例除Ph(+)外,还出现额外染色体改变,占20.6%,分别为+8,+17,-Y,-7,-11,-16,-17,-19,-20及超二倍体(>46条)等。绝大部分患者经干扰素,羟基脲治疗后Ph(+)阳性率无变化。结论染色体核型分析不仅有助于CGL的诊断和鉴别诊断,还是监测病情缓解或复发的重要指标。

Objective Using the method of cytogentics to evaluate the clinical diagnosis, effectiveness and prognosis in patients with CGL.Methods Bone marrow cell cytogenetic analysis was performed by direct method and/or 24h culture method. RHG band-ing was used for karyotype analysis.Results 131patients with CGL, 121 cases（92.4%） were ph positive in each phase of CGL. 10 cases （7.6%） were ph negative. In 102 of 121 eases （84.3%）,the rate of ph positive chromosome were 100 percentage. Those in 19 cases（15.7%） were detected by the positive percentage from 45% to 96%. In 27 cases （20.6%）,besides the ph positive, the abnormality were detected, such as ＋8, ＋ 17,-7,-Y,-11,-16,-17,-19,-20 and hyperploid.Most of them the percentage of ph positive didn＇t change after the treatment of IFN or hydroxyurea. Conclusions The karyotype analysis was not only useful to the diagnosis and the differentiate, but also important to monitor the remission or relapse of CGL.