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慢性淋巴细胞白血病染色体异常与预后指标的关系

发布时间:2018-11-03 16:58
【摘要】:目的:运用荧光原位杂交技术(fluorescence in situ hybridization, FISH)和常规染色体显带技术(conventional cytogenetics, CC)法检测慢性淋巴细胞白血病患者染色体的异常并比较这两种方法的差异,同时探讨这些染色体异常与其他预后指标的关系。方法:回顾性分析36例已经确诊的患者并收集相关临床资料,其中男性23例,女性13例。应用着丝粒探针CSP12(+12)和序列特异性探针ATM (11q22. 3)、D13S319 (13q14.3)、P53 (17p13.1)进行FISH检测。同时分析染色体异常与其他预后指标的关系。结果:36例患者中有例7患者通过CC检测到染色体异常,FISH检测的染色体异常结果如下,36例CLL患者染色体异常有24例,其中Del(13q)单独缺失者13例;Del(17p)单独缺失者2例;12三体者5例;Del(1lq)单独缺失者1例。复杂染色体异常3例,其中Del(1lq)伴Del(13q)者1例;12三体伴Del(13q)者1例,12三体伴Del(1lq)者1例。根据不同染色体异常提示的预后不同,将正常核型和Del(13q)者分到低危组,12三体者分到中危组,Del(11q)、Del(17p)及复杂染色体异常者分到高危组,并分析染色体异常与年龄、白细胞计数、血红蛋白计数、血小板计数、淋巴细胞绝对值、β2-微球蛋白、乳酸脱氢酶、ZAP-70、Rai分期、CD38、IgVH、Ki-67的关系。CD38 (r=0.702, P0.01)、ZA P-70 (r=0.68, P0.01)、Ki-67 (γ=0.46, P=0.005)、Rai分期(r=0.38,P=0.02)在不同分组中存在差异且差异有统计学意义。结论:1)FISH在检测CLL染色体异常方面检出率较CC高。2)Del (13q)、Del (11q)、Del (17p)、12三体是慢性淋巴细胞白血病中常见的染色体异常。3)FISH检测出的染色体异常与Rai分期、CD38、ZAP-70、Ki-67呈正相关。
[Abstract]:Objective: to detect chromosome abnormalities in patients with chronic lymphoblastic leukemia by fluorescence in situ hybridization (fluorescence in situ hybridization, FISH) and conventional chromosome banding technique (conventional cytogenetics, CC). At the same time, the relationship between these chromosomal abnormalities and other prognostic indexes was discussed. Methods: a retrospective analysis was made on 36 patients, including 23 males and 13 females. The centromere probe CSP12 (12) and sequence-specific probe ATM (11q22) were used. 3), D13S319 (13q14.3) and p53 (17p13.1) were detected by FISH. At the same time, the relationship between chromosomal abnormalities and other prognostic indexes was analyzed. Results: chromosome abnormality was detected by CC in 7 out of 36 patients. The results of chromosome abnormality detected by FISH were as follows: 24 cases with chromosome abnormality in 36 cases with CLL, 13 cases with deletion of Del (13q) alone; Del (17 p) was absent alone in 2 cases and trisomy 12 in 5 cases (; Del (1lq) in 1 case. There were 3 cases of complex chromosomal abnormalities, including Del (1lq) with Del (13q) in 1 case, trisomy 12 with Del (1lq) in 1 case. Patients with normal karyotype and Del (13q) were divided into low risk group, 12 trisomy group into, Del (11q), Del (17p group and those with complex chromosomal abnormality were divided into high risk group according to the prognosis of different chromosomal abnormalities, the patients with normal karyotype and Del (13q) were divided into low risk group, 12 trisomy group and, Del (11q), Del (17p group. The relationship between chromosome abnormality and age, white blood cell count, hemoglobin count, platelet count, lymphocyte absolute value, 尾 2-microglobulin, lactate dehydrogenase, ZAP-70,Rai stage and CD38,IgVH,Ki-67 were analyzed. P0.01), ZA P-70 (RP0. 68, P0. 01), Ki-67 (纬 = 0. 46, P0. 005), Rai stage) were significantly different in different groups. Conclusion: 1) the detection rate of CLL chromosome abnormality by FISH is higher than that by CC. 2) Del (13q), Del (11q), Del (17p). Trisomy 12 is a common chromosome abnormality in chronic lymphoblastic leukemia. 3) chromosome abnormality detected by FISH is positively correlated with Rai stage and CD38,ZAP-70,Ki-67.
【学位授予单位】:新疆医科大学
【学位级别】:硕士
【学位授予年份】:2015
【分类号】:R733.72


本文编号:2308386

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