弥漫大B细胞淋巴瘤患者染色体改变及其与生存期的关系

Chromosomal abnormalities and its relevance to survival time in diffuse large B-cell lymphoma

目的明确弥漫大B细胞淋巴瘤（DLBCL）患者常见的染色体改变及其与生存期的关系。方法采用改进的染色体制备方法，对30例经病理活组织检查确诊的DLBCL患者进行染色体分析，并予相应的化疗方案处理，统计各组患者的生存期。结果28例获得满意的染色体分裂象，其中5例染色体核型正常，8例为多倍体，4例发生t（14；18）（q32；q21），5例发生t（3；14）（q27；q32），2例发生t（2；3）（p11；q27），1例发生t（3；22）（q27；q11），2例涉及7号染色体与其他染色体问异位，1例涉及17号染色体与其他染色体间异位。染色体核型正常以及发生t（14；18）（q32；q21）和3q＋改变的患者，生存期分别为（71．4±2．0）、（67．9±1．6）、（69．1±1．7）个月，较多倍体、7号染色体异常、17号染色体异常患者明显延长（均P〈0．05）。Ⅰ＋Ⅱ期患者中，正常染色体核型、t（14；18）（q32；q21）以及3q＋患者生存期较发生多倍体改变患者以及7号染色体发生改变患者明显延长（P〈0．05）。Ⅲ＋Ⅳ期患者中，发生多倍体改变患者生存期亦较发生t（14；18）（q32；q21）、3q＋以及正常染色体核型患者缩短（P〈0．05）。Ⅰ＋Ⅱ期正常染色体核型、t（14；18）（q32；q21）、3q＋以及多倍体患者与Ⅲ＋Ⅳ期生存期比较，差异均有统计学意义（均P〈0．05）。结论依据恶性淋巴瘤患者染色体改变及其与恶性淋巴瘤分期等的相关性研究，可以预测淋巴瘤患者的治疗效果、生存期等。

Objective To study the relationship between chromosomal abnormalities of diffuse large B- cell lymphoma and its survival time. Methods Chromosome preparations were made by using modified method. Karyotypes were analyzed by stain of G-banding. And all patients were treated by chemotherapy. All patients＇ survival time was calculated. Results Mitotic cells that could be used for analysis were found in 28 cases. 5 of 28 karyotypes were normal and 8 cases were polyploid. There were 4 cases with t（14,18） （q32;q21）, 5 cases with t（3;14）（q27;q32）,2 cases with t（2;3）（pll;q27）,l case with t（3;22）（q27;qll） respectively. There were 2 cases with ectopia between 7 chromosome and other chromosomes and 1 case with ectopia between 17 chromosome and other chromosomes. The survival time of patients with normal karyotype, t（14,18） （q32; q21） or 3q＋ was longer than that of other groups. The survival time of group in I, 1I stages was longer than that in 111, IV stages. Conclusion The treatment, survival time and prognosis could be expected according to chromosomal abnormalities and its relevance to stages in diffuse large B-cell lymphoma.