急性髓系白血病患者骨髓杯状核细胞阳性与FMS样酪氨酸激酶3基因内部串联重复突变相关性的Meta分析

Meta analysis on the relationship between cuplike nuclei morphology and FLT3-ITD mutation in acute myeloid leukemia

目的评价急性髓系白血病（AML）患者骨髓杯状核细胞阳性与FMS样酪氨酸激酶3基因内部串联重复（FLT3－ITD）突变的相关性。方法检索国内外各类大型数据库中2000年至2011年发表的有关AML患者杯状核细胞阳性与发生FLT3－ITD突变关系的文献，采用Meta分析方法，利用Statal1软件评价杯状核细胞阳性与FLT3－ITD突变之间的关系。计算OR值及其95％CI，Begg检验法和Egger检验法评价发表性偏倚。结果共纳入4篇文献，包括225例患者，其中杯状核细胞阳性的AML患者76例，杯状核阴性的AML患者149例（所有研究的AML患者均除外AML-M3、M5型）。对总体人群进行Meta分析，发现骨髓杯状核细胞阳性与FLT3．ITD突变的发生密切相关（OR=2．59，95％C11．55—4．33，P=0．00）。结论AML患者杯状核阳性与FLT3．ITD突变相关，该形态学特点可以指导临床医生合理选择检测项目。杯状核细胞阳性的患者也许可以成为AML的一种新亚型。

Objective To investigate the association between cuplike nuclei morphology and FLT3-ITD mutation, so as to provide evidence for the minor classification of AML. Methods The articles on the association of cuplike nuclei morphology and FLT3-ITD mutation were retrieved by searching international and national databases from 1999 to 2011. The relationship was assessed by meta analysis with Statal 1 software. The OR value and confidence interval （Co were calculated, and the publication bias was assessed by Begg test and Egger test. Results There was significant difference between cuplike nuclei morphology appearance and FLT3-ITD mutation （OR = 2.59, 95 % CI 1.55-4.33, P = 0.00）. Results from both Begg＇s test and Egger＇ s test did not show significant difference indicating that there was no publication bias existed.Conclusion The uncommon morphologic variant of AML with cuplike nuclei is highly associated with FLT3-ITD mutation, and the presence of cuplike nuclei in AML represents a distinctive morphologic finding that can be used to prioritize the molecular workup of patients with AML.