慢性粒细胞白血病的核型及其预后意义

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 116例采用骨髓细胞直接法和 (或 )短期 ( 2 4h)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 116例CGL中 ,发现 110例Ph( +) ,在病程各期 (慢性期、加速期、急变期 )均出现 ,占 94.8%。 6例Ph( -) ,占 5 .17%。其中 96例Ph( +)细胞为 10 0 % ,占 87.2 %。 14例Ph( +)细胞为 41.6%～ 93 .1% ,占 12 .7% ,核型呈嵌合状态。 12例除Ph( +)外 ,还出现额外染色体改变 ,占 10 .9%。分别为双Ph ,+8,-Y ,-7及超二倍体 ( >46条 )。绝大部分患者经干扰素、羟基脲治疗后Ph( +)阳性率不变。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 banding was used for karyotype analysis.Results:116 patients with CGL, 110 cases(94.8%) were ph positive in each phase of CGL. 6 cases (5.17%) were ph negative. In 96 of 100 cases (87.2%), the rate of ph positive chromosome were 100 percentage. Those in 14 cases(12.7%) were detected by the positive percentage from 41.6% to 93.1%. They were the chimera of ph positive and ph negative. In 12 cases, besides the ph positive,the abnormality were detected, such as double ph,+8,-7,-Y and hyperploid. Most of them the percentage of ph positive didn't change after the treatment of IFN or hydroxyurea. But one patient who received Glive STIS70, the abnormality decreased by 60%.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.