慢性髓性白血病急性变时染色体变化的研究

目的 :探讨慢性髓性白血病 (CML )急性变时染色体的变化及与预后的关系。方法 :取 2 0例 CML病人急性变前、后外周血或骨髓液 ,处理后制片 ,Giem sa染色 ,G显带或 R显带 ,在显微镜下摄影后配对、分析。结果 :急性变前 ph染色体阳性 18例 ,阴性 2例。急性变后 19例附加出现了新的染色体异常。染色体数目异常超二倍体占 15 /2 0。附加出现的异常染色体中 ,+8、+19、+2 2 q-及 i(17q)中的 1个或多个异常占 13/ 2 0。4/ 2 0例在临床和血液学尚未出现急性变就出现了附加染色体异常。除 2例失去随访外 ,其余急性变后均死亡 ,急性变后中位生存期 2 .2个月。结论 :慢性髓性白血病慢性期 (急性变前 )出现 ph以外的染色体异常提示预后不良。急性变后染色体数目改变以出现超二倍体改变者预后差。染色体核型改变以非随机同时出现 +8、+19、+2 2

STUDIES OF THE CHARACTERISTIC FEATURES OF KI-1 POSITIVE NON-HODGKIN'S LYMPHOMA

The clinical histopathological and immuno-phenotypic features in 5 patients with Ki-1 positive non-Hodgkin's lymphoma (NHL) were studied. When firstseen, 4 patients presented enlargement of superficiallymph nodes, with skin lesions in 2 patients. Two patientsin stage Ⅳ with fever, hepato-splenomegaly and bonemarrow invasion, died. Histologically, the tumor cellsshowed diffused or patchy hyperplasia. The cells wererelatively large in size, rich in basophilic or slightlyeosinophilic cytoplasm with irregular-shaped nuclei,prominent nucleoli, and distinct anaplasia andpleomorphism. Some of the cells looked very much likethe Reed-Sternberg cells. Multinucleated giant cells wereseen. Immunophenotypically, all the cells were CD30 (Ki-1) and CD25 (IL-2 receptor) positive but CD15 (Leu M1)negative. Thus, the 5 patients with Ki-1 positive NHLwere all of T cell type.

Ki-1阳性非Hodgkin淋巴瘤特点的研究

作者对５例Ｋｉ－１阳性非Ｈｏｄｇｋｉｎ淋巴瘤（ＮＨＬ）的临床、病理组织学及免疫学表现型特点进行了分析。５例患者全部为男性，初诊时４例表现为浅表淋巴结肿大，伴有皮肤病变者２例。５例中２例死亡。这２例生前还伴有发热、肝脾肿大和骨髓浸润，临床分期都是Ⅳ期。组织学所见：肿瘤细胞呈弥漫性或集簇性增生，细胞较大，有显著间变性和多形性，胞浆丰富，嗜碱或淡酸性，胞核多不规则，核仁明显，有者酷似Ｒｅｅｄ－ｓｔｅｒｎｂｅｒｇ（Ｒ－Ｓ）细胞，可见多核巨细胞。免疫学表现型除ＣＤ３０（Ｋｉ－１）阳性外，ＣＤ２５（ＩＬ－２Ｒ）也都阳性，而ＣＤ１５（ＬｅｕＭ１）均阴性。５例均为Ｔ细胞性。在与霍奇金病（ＨＤ）的鉴别方面，ＨＤ和Ｒ－Ｓ细胞同时出现ＣＤ３０、ＣＤ２５和ＣＤ１５抗原，而Ｋｉ－１阳性ＮＨＬ，ＣＤ１５多阴性，在鉴别上有重要意义。