85例成人白血病染色体核型分析

85 example adult leukemia chromosome karyotype analysis

目的本文旨在分析85例成人白血病患者染色体核型异常分布情况及各亚型核型变化的特征。方法根据患者的临床表现、血象、骨髓象和细胞化学染色初步确定白血病的诊断。然后进行形态学、免疫学、细胞遗传学、分子生物学检测。结果不同类型白血病患者染色体检测结果有着明显的不同,在AML、ALL、CML、CLL、CMML患者中,异常核型分别为64.4%(38/59)、73.3%(11/15)、100%(5/5)、66.7%(2/3)、66.7%(2/3),平均染色体核型异常患者占68.2%(58/85)。从各种白血病染色体核型异常的特征来看,除了病例数较少的白血病染色体异常没有可比性外,M3和CML染色体变化较一致,分别以t(15;17)(q22;q11.2);t(9;22)(q34;q11.2)改变为主;而其他类型白血病染色体异常存在着不一致性,特别是M4有着明显的不一致性。结论根据白血病染色体核型异常分析,复杂核型则是预后不良的标志。有些特定的染色体异常与FAB亚型密切相关。因此,染色体异常核型分析在白血病诊断、分型、治疗及预后判断诸方面起着十分重要的作用。

Objective This article aims to analyze 85 cases of adult leukemia patients with chromosome abnormal- ities and the distribution of karyotype changes in the characteristics of subtypes. Methods According to clinical mani- festations, hemogram, bone marrow and cell staining, as a preliminary to determine the diagnosis of leukemia. Then morphology,immunology, cytogenetics, molecular biology testing. Results Different types of leukemia patients have a chromosome test results markedly different from that in AML, ALL, CML, CLL, CMML patients, the abnormal karyotype were 64.4% （38/59） ,73.3% （ 11/15 ）, 100% （5/5） ,66.7% （2/3） ,66.7% （2/3）, the average chromosome abnormal- ity accounted for 68.2% （58/85）. From a variety of leukemia chromosome abnormalities characteristic, in addition to the number of cases of leukemia with fewer chromosomal abnormalities are not comparable things, M3 and CML com- pared with the same chromosomal changes,respectively,t （15; 17） （q22; qll. 2） ; t （9; 22） （q34; q11.2） changes in the main ; while other types of leukemia, there are inconsistencies chromosomal abnormalities, especially the M4 there is a clear inconsistency. Conclusions According to leukemia, abnormal chromosome karyotype analysis, a complex karyotype is a sign of poor prognosis. Some of the specific chromosomal abnormalities and the FAB subtypes closely re- lated. Therefore, the chromosomal abnormality karyotype analysis in leukemia diagnosis, classification, treatment and prognosis aspects play an important role.