中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2009年
7期
789-793
,共5页
李承文%代芸%薄丽津%刘旭平%秦爽%于成龙%刘世和%王建祥
李承文%代蕓%薄麗津%劉旭平%秦爽%于成龍%劉世和%王建祥
리승문%대예%박려진%류욱평%진상%우성룡%류세화%왕건상
白血病%骨髓检查%原位杂交,荧光%诊断,鉴别
白血病%骨髓檢查%原位雜交,熒光%診斷,鑒彆
백혈병%골수검사%원위잡교,형광%진단,감별
Leukemia%Bone marrow examination%In situ hybridization,fluorescence%Diagnosis,differential
目的 探讨联合骨髓形态学染色和荧光原位杂交(MGG-FISH)技术在Ph染色体阳性急性淋巴细胞白血病(Ph+ALL)和慢性粒细胞白血病急性淋巴细胞白血病变(CML-LBC)鉴别诊断中的临床应用价值.方法 应用BCR(绿色)和ABL(橘红色)双色双融合探针,通过MGG-FISH技术对4例Ph+ALL患者、4例CML-LBC患者、1例CML急性白血病变合并淋巴瘤、1例CML急性混合细胞白血病变患者的骨髓涂片标本进行检测,依据形态学分别检测10份标本红细胞系、粒细胞系和淋巴细胞系的BCR/ABL融合信号阳性细胞百分率.结果 通过MGG-FISH方法分析,4份Ph+ALL骨髓标本红细胞系未累及,BCR/ABL融合信号阳性细胞百分率均为0%;粒细胞系阳性率分别为11%(1/9)、8%(1/12)、0%(0/8)、10%(1/10);淋巴细胞系阳性率分别为97%(76/78)、98%(87/89)、98%(97/99)、97%(75/77).4份CML-LBC骨髓标本红细胞系阳性率分别为100%(8/8)、91%(10/11)、82%(9/11)、88%(7/8);粒细胞系阳性率分别为89%(8/9)、96%(94/98)、100%(47/47)、98%(40/41);淋巴细胞系阳性率分别为96%(78/81)、93%(52/56)、96%(68/71)、95%(58/61).其余2份标本阳性率均超过80%,且通过MGG-FISH分析鉴定了恶性克隆的来源.结论 MGG-FISH技术可以准确、快速地对原发性Ph+ALL和CML-LBC进行鉴别,并可进行克隆源性分析.
目的 探討聯閤骨髓形態學染色和熒光原位雜交(MGG-FISH)技術在Ph染色體暘性急性淋巴細胞白血病(Ph+ALL)和慢性粒細胞白血病急性淋巴細胞白血病變(CML-LBC)鑒彆診斷中的臨床應用價值.方法 應用BCR(綠色)和ABL(橘紅色)雙色雙融閤探針,通過MGG-FISH技術對4例Ph+ALL患者、4例CML-LBC患者、1例CML急性白血病變閤併淋巴瘤、1例CML急性混閤細胞白血病變患者的骨髓塗片標本進行檢測,依據形態學分彆檢測10份標本紅細胞繫、粒細胞繫和淋巴細胞繫的BCR/ABL融閤信號暘性細胞百分率.結果 通過MGG-FISH方法分析,4份Ph+ALL骨髓標本紅細胞繫未纍及,BCR/ABL融閤信號暘性細胞百分率均為0%;粒細胞繫暘性率分彆為11%(1/9)、8%(1/12)、0%(0/8)、10%(1/10);淋巴細胞繫暘性率分彆為97%(76/78)、98%(87/89)、98%(97/99)、97%(75/77).4份CML-LBC骨髓標本紅細胞繫暘性率分彆為100%(8/8)、91%(10/11)、82%(9/11)、88%(7/8);粒細胞繫暘性率分彆為89%(8/9)、96%(94/98)、100%(47/47)、98%(40/41);淋巴細胞繫暘性率分彆為96%(78/81)、93%(52/56)、96%(68/71)、95%(58/61).其餘2份標本暘性率均超過80%,且通過MGG-FISH分析鑒定瞭噁性剋隆的來源.結論 MGG-FISH技術可以準確、快速地對原髮性Ph+ALL和CML-LBC進行鑒彆,併可進行剋隆源性分析.
목적 탐토연합골수형태학염색화형광원위잡교(MGG-FISH)기술재Ph염색체양성급성림파세포백혈병(Ph+ALL)화만성립세포백혈병급성림파세포백혈병변(CML-LBC)감별진단중적림상응용개치.방법 응용BCR(록색)화ABL(귤홍색)쌍색쌍융합탐침,통과MGG-FISH기술대4례Ph+ALL환자、4례CML-LBC환자、1례CML급성백혈병변합병림파류、1례CML급성혼합세포백혈병변환자적골수도편표본진행검측,의거형태학분별검측10빈표본홍세포계、립세포계화림파세포계적BCR/ABL융합신호양성세포백분솔.결과 통과MGG-FISH방법분석,4빈Ph+ALL골수표본홍세포계미루급,BCR/ABL융합신호양성세포백분솔균위0%;립세포계양성솔분별위11%(1/9)、8%(1/12)、0%(0/8)、10%(1/10);림파세포계양성솔분별위97%(76/78)、98%(87/89)、98%(97/99)、97%(75/77).4빈CML-LBC골수표본홍세포계양성솔분별위100%(8/8)、91%(10/11)、82%(9/11)、88%(7/8);립세포계양성솔분별위89%(8/9)、96%(94/98)、100%(47/47)、98%(40/41);림파세포계양성솔분별위96%(78/81)、93%(52/56)、96%(68/71)、95%(58/61).기여2빈표본양성솔균초과80%,차통과MGG-FISH분석감정료악성극륭적래원.결론 MGG-FISH기술가이준학、쾌속지대원발성Ph+ALL화CML-LBC진행감별,병가진행극륭원성분석.
Objective To evaluate the clinical application of May-Grunwald-Giemsa staining followed by fluorescence in situ hybridization (MGG-FISH) technique in the differentiation diagnosis of Ph-chromosome positive acute lymphoid leukemia (Ph + ALL) from chronic myeloid leukemia in lymphoid blast crisis(CML-LBC). Methods The bone marrow smears of 4 patients with Ph+ ALL, 4 patients with CML-LBC, 1 patient with CML in myelocytic blast crisis complicated with lymphoma and 1 patient with CML in mixed blast crisis were assayed with the MGG-FISH technique in which the spectrum green labeled BCR and spectrum orange labeled ABL dual color dual fusion probes were used. Based on the morphological classification, the percentages of BCR-ABL positive cells were subsequently determined respectively in the erythroid, myeloid and lymphoid hneages for the 10 specimens. Results According to the MGG-FISH analysis, the erythroid lineage was not involved in the 4 Ph+ ALL specimens without BCR/ABL positive cells. While the BCR/ABL positive percentage of myeloid cells was 11% (1/9), 8% (1/12), 0% (0/8) and 10% (1/10) respectively and that of lymphoid cells was 97% (76/78), 98% (87/89), 98% (97/99) and 97% (75/77) respectively. On the other hand, the BCR/ABL positive percentage was 100% (8/8), 91% (10/11), 82% (9/11), 88% (7/8) in the erythroid lineage, 89% (8/9), 96% (94/98), 100% (47/47), 98% (40/41)in the myeloid lineage and 96% (78/81), 93% (52/56), 96% (68/71), 95% (58/61) in the lymphoid lineage respectively for the 4 CML-LBC specimens. The BCR/ABL positive percentages of the other 2 specimens were all above 80% and through MGG-FISH analysis we also identified the source of the malignant clones and ascertained the diagnosis of the 2 patients. Conclusions The MGG-FISH technique has proved useful in providing rapid and precise differentiation between Ph + ALL and CML-LBC. The source of the malignant clones can also be analyzed by this technique.
