荧光原位杂交检测117例多发性骨髓瘤细胞遗传学异常及预后分析

Cytogenetic Abnormalities and Outcomes of 117 Patients with Multiple Myeloma Detected by FISH

目的:分析荧光原位杂交(FISH)检测初诊多发性骨髓瘤患者骨髓细胞遗传学异常及预后。方法:回顾性分析解放军总医院血液科及老年血液科7年以来初诊的117例多发性骨髓瘤患者FISH检测骨髓细胞遗传学异常结果及生存情况。结果:FISH检测细胞遗传学异常检出率76.9%(90/117),阳性率最高者为1q21+(71.1%),其次是13q-(56.6%)。交叉性比较显示,13q-与17p13-的相关性以及t(11;14)与t(4;14)的相关性差异有统计学意义。13q-患者与13q正常患者生存曲线有分离趋势,但统计学差异无显著性。余细胞遗传学异常与正常患者的生存差异也均无统计学意义。结论:FISH检测多发性骨髓瘤细胞遗传学异常阳性率较高,但预后评估需要更大样本量更长时间随访研究的数据。

Objective:To analyze the cytogenetic abnormalities and prognostic outcomes of patients with multiple myeloma(MM) detected by fluorescence in situ hybridization(FISH).Methods:The clinical record of 117 newly-diagnosed patients with MM treated in department of hematology and geriatric hematology of our hospital for 7 years were collected,and their molecular cytogenetic abnormalities detected by FISH and the clinical outcome were analyzed retrospectively.Results:The detected rate of cytogenetic abnormality was 76.9%(90/117),the most common abnormality deteted by FISH was 1q21 +(71.1%),followed by 13q-(56.6%).The cross comparison method showed that 13q- and 17pl3-,t(11;14) and t(4;14) were related respectively.All the patients with cytogenetic abnormalities showed no significant difference in the overall survival from cytogenetic normal patients.Conclusion:The positive rate of molecular cytogenetic abnormalities detected by FISH in MM patients is high,but data from larger and longer studies are needed to evaluate the prognostic outcomes.