CAJ | 학술논문

目的研究伴有骨髓侵犯的B细胞非霍奇金淋巴瘤(NHL)患者的染色体异常特点,探讨其预后意义.方法回顾分析在我院诊断为骨髓侵犯且具有完整染色体结果的126例B细胞NHL患者的临床资料.染色体检查采取24 h短期培养法,R显带技术分析.结果 ①126例患者中弥漫大B细胞淋巴瘤(DLBCL)49例,淋巴浆细胞淋巴瘤(LPL)24例,套细胞淋巴瘤(MCL)21例,滤泡性淋巴瘤(FL)12例,边缘区淋巴瘤(MZL)11例,小细胞淋巴瘤(SLL)9例.②126例患者中52例(41.3%)患者存在染色体异常,其中克隆性染色体异常38例,非克隆性染色体异常14例.22例为单一染色体异常,30例具有两种以上染色体异常.38例具有可分析的克隆性染色体异常者中,假二倍体22例(57.9%),低二倍体6例(15.8%),超二倍体10例(26.3%).14例具有可分析的非克隆性染色体异常者中,假二倍体10例(71.4%),超二倍体4例(28.6%).DLBCL、MCL、MZL、LPL、FL、SLL患者中分别有36例(73.4%)、8例(38.1%)、4例(36.4%)、2例(8.3%)、1例(8.3%)、1例(11.1%)检出染色体异常;③克隆性染色体异常(P=0.049)、具有两种以上染色体异常(P=0.045)以及第2号(P=0.011)、3号(P=0.013)、9号(P=0.048)、11号(P=0.044)、17号(P=0.002)、18号(P=0.015)、20号(P=0.004)染色体克隆性异常为DLBCL的预后不良因素.有两种以上染色体异常(P=0.039)以及3号(P=0.028)、13号(P=0.045)染色体克隆性异常是MCL的预后不良因素.未发现特定的染色体异常与其他淋巴瘤类型的预后相关.结论采取骨髓标本进行染色体分析,侵袭性淋巴瘤染色体异常率高于惰性淋巴瘤;以复杂核型异常为主,部分特定染色体异常有一定的预后意义.
목적 연구반유골수침범적B세포비곽기금림파류(NHL)환자적염색체이상특점,탐토기예후의의.방법 회고분석재아원진단위골수침범차구유완정염색체결과적126례B세포NHL환자적림상자료.염색체검사채취24 h단기배양법,R현대기술분석.결과 ①126례환자중미만대B세포림파류(DLBCL)49례,림파장세포림파류(LPL)24례,투세포림파류(MCL)21례,려포성림파류(FL)12례,변연구림파류(MZL)11례,소세포림파류(SLL)9례.②126례환자중52례(41.3%)환자존재염색체이상,기중극륭성염색체이상38례,비극륭성염색체이상14례.22례위단일염색체이상,30례구유량충이상염색체이상.38례구유가분석적극륭성염색체이상자중,가이배체22례(57.9%),저이배체6례(15.8%),초이배체10례(26.3%).14례구유가분석적비극륭성염색체이상자중,가이배체10례(71.4%),초이배체4례(28.6%).DLBCL、MCL、MZL、LPL、FL、SLL환자중분별유36례(73.4%)、8례(38.1%)、4례(36.4%)、2례(8.3%)、1례(8.3%)、1례(11.1%)검출염색체이상;③극륭성염색체이상(P=0.049)、구유량충이상염색체이상(P=0.045)이급제2호(P=0.011)、3호(P=0.013)、9호(P=0.048)、11호(P=0.044)、17호(P=0.002)、18호(P=0.015)、20호(P=0.004)염색체극륭성이상위DLBCL적예후불량인소.유량충이상염색체이상(P=0.039)이급3호(P=0.028)、13호(P=0.045)염색체극륭성이상시MCL적예후불량인소.미발현특정적염색체이상여기타림파류류형적예후상관.결론 채취골수표본진행염색체분석,침습성림파류염색체이상솔고우타성림파류;이복잡핵형이상위주,부분특정염색체이상유일정적예후의의.
Objective To study the cytogenetic characteristics of B cell non-Hodgkin' s lymphoma (B-NHL) with bone marrow involvement, and to explore the clinical significance and prognosis. Methods Clinical data of 126 B-NHL patients with bone marrow involement diagnosed in our hospital were retrospectively analyzed. Chromosome banding analysis was performed after 24 h culture. Results ①The B-NHLs included were diffuse large B-cell lymphoma (DLBCL) 38.9% (49 cases), lymphoplasmacytic lymphoma (LPL) 19% (24 cases), mantle cell lymphoma(MCL) 16.7% (21 cases), follicular lymphoma (FL) 9.5% (12 cases), marginal zone lymphoma (MZL) 8.7% (11 cases) and small lymphocytic lymphoma (SLL) 7.1% (9 cases). ②Chromosome aberrations (CA) were detected in 52 of 126 patients(41.3% ) by conventional cytogenetics( CC), including clonal CA 38 cases, and non-clonal CA 14 cases. Ploidy levels in 38 clonal CA cases were pseudodiploid (57.9%), hypodiploid ( 15.8% ) and hyperdiploid (26.3%). The incidence of chromosomal abnormalities among DLBCL, MCL, MZL, LPL, FL and SLL was 73.4%,38.1%, 36.4%, 8.3%, 8.3% and 11.1%, respectively. ③Clonal CA, CA more than two kinds, and CA of chromosomes 2, 3, 9, 11, 17, 18 and 20 were associated with shorter overall survival (OS) in DLBCL.More than two kinds of CA and CA of chromosome 3, 13 were associated with shorter OS in MCL. Conclusions The incidence of CA was higher in aggressive lymphoma than in indolent lymphoma. Complex CA were quite common, and some specific CA might have prognostic significance.