一例CML患者联合检测胸水染色体核型病例复习

A Case Review of a CML Patient with Combined Detection of Chromosomal Karyotype of Pleural Fluid

目的:探讨1例慢性粒细胞性白血病(Chronic Myelogenous Leukemia, CML)患者胸水染色体核型分析检测的意义。方法:对本院1例慢性粒细胞性白血病(CML)患者的胸水进行细胞形态学、免疫学、细胞遗传学、分子生物学(MICM)检测并进行联合分析和文献复习。结果:该患者胸水检测:形态学可见25%原始细胞;免疫分型可见一群细胞占40.7%,考虑为髓系原始细胞,其表达CD34、CD38、CD13、HLA-DR,不表达CD117、CD33、CD11b、CD16、CD56、CD4、CD8、CD3、CD10、CD19、CD20、CD81、Kappa、Lambda;BCR/ABL (P210)融合基因检查:阳性,比例203.94%;染色体核型分析为复杂核型:48~50, XY, del(2)(p21), i(6)(p10), 8, 8, t(9;22)(q34;q11), t(9;22)(q34;q11), 15, 22, inc[cp20]。结论:慢性粒细胞性白血病患者的胸腔积液检测,除其他常规检测外,染色体核型分析检测是必不可少的一部分,核型分析检测对良恶性胸腔积液的鉴别有作用,对患者疾病进展和预后评估也有重要意义。

Objective: To investigate the significance of chromosomal karyotype analysis of pleural fluid in a chronic myelogenous leukemia (CML) patient. Methods: Cytomorphology, immunology, cytogenetics, and molecular biology (MICM) were performed on the pleural fluid of one patient with chronic myeloid leukemia (CML) in our hospital, and joint analysis was carried out and literature review. Results: Pleural effusion test showed that 25% blasts were visible on morphology. Immunophenotyping showed that a group of cells accounted for 40.7%, which was considered to be myeloid blasts, which expressed CD34, CD38, CD13, HLA-DR, but did not express CD117, CD33, CD11b, CD16, CD56, CD4, CD8, CD3, CD10, CD19, CD20, CD81, Kappa, Lambda. BCR/ABL (P210) fusion gene test: positive, 203.94%;Karyotype analysis of chromosomes was complex karyotype: 48~50, XY, del(2)(p21), i(6)(p10), 8, 8, t(9;22)(q34;q11), t(9;22)(q34;q11), 15, 22, inc[cp20]. Conclusion: In the detection of pleural effusion in patients with chronic myelogenous leukemia, the detection of chromosome karyotype analysis is an essential part. Karyotype analysis is effective in the identification of benign and malignant pleural effusion, and also has great significance in the evaluation of disease progression and prognosis in patients.