肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2014年
2期
110-113
,共4页
刘虹%安利%张玥玥%王增胜%王晓敏
劉虹%安利%張玥玥%王增勝%王曉敏
류홍%안리%장모모%왕증성%왕효민
骨髓增生异常综合征%染色体%核型%预后
骨髓增生異常綜閤徵%染色體%覈型%預後
골수증생이상종합정%염색체%핵형%예후
Myelodysplastic syndrome%Chromosome%Karyotypes%Prognosis
目的 探讨骨髓增生异常综合征(MDS)各亚型中的染色体核型分布特点及其与预后的关系.方法 回顾分析151例原发性MDS患者的染色体核型,比较各亚型中的染色体核型分布特点、国际预后积分系统(IPSS)评分、白血病转化率及死亡率等,并比较其在汉族与维吾尔族MDS患者中有无民族差异性.结果 所有患者核型异常检出率为55.0％(83/151),其中简单异常占53.0％(44/83),复杂异常占47.0％(39/83).伴多系病态造血的难治性血细胞减少症(RCMD)、原始细胞过多的难治性贫血(RAEB)-Ⅰ、RAEB-Ⅱ亚型中复杂异常的检出率明显高于难治性贫血(RA)、环形铁粒幼细胞增多的RA(RARS)亚型.核型异常涉及各条染色体,发生频率较高的染色体畸变依次为-5/5q-、-7/7q-、+8、-20/20q-、-X/-Y、i(17q)、9p-/9q-、+21等.IPSS评分在各亚型中差异有统计学意义(x2=117.802,P＜0.01);高危组的核型异常检出率明显高于低危组和中危组(均P＜0.05).随访151例患者白血病转化率和死亡率分别为25.2％(38/151)和43.7％(66/151),核型异常者白血病转化率和死亡率明显高于核型正常者(均P＜0.05).核型异常者白血病转化中位时间和生存中位时间均短于核型正常者.汉族与维吾尔族MDS患者各亚型分布、核型异常特点及白血病转化率、死亡率等方面差异均无统计学意义(均P＞0.05).结论 染色体核型异常在MDS不同亚型中存在差异且与预后密切相关,是影响MDS患者病情进展及预后的重要指标,对MDS的正确诊断、病情监测及预后评估有重要意义.
目的 探討骨髓增生異常綜閤徵(MDS)各亞型中的染色體覈型分佈特點及其與預後的關繫.方法 迴顧分析151例原髮性MDS患者的染色體覈型,比較各亞型中的染色體覈型分佈特點、國際預後積分繫統(IPSS)評分、白血病轉化率及死亡率等,併比較其在漢族與維吾爾族MDS患者中有無民族差異性.結果 所有患者覈型異常檢齣率為55.0％(83/151),其中簡單異常佔53.0％(44/83),複雜異常佔47.0％(39/83).伴多繫病態造血的難治性血細胞減少癥(RCMD)、原始細胞過多的難治性貧血(RAEB)-Ⅰ、RAEB-Ⅱ亞型中複雜異常的檢齣率明顯高于難治性貧血(RA)、環形鐵粒幼細胞增多的RA(RARS)亞型.覈型異常涉及各條染色體,髮生頻率較高的染色體畸變依次為-5/5q-、-7/7q-、+8、-20/20q-、-X/-Y、i(17q)、9p-/9q-、+21等.IPSS評分在各亞型中差異有統計學意義(x2=117.802,P＜0.01);高危組的覈型異常檢齣率明顯高于低危組和中危組(均P＜0.05).隨訪151例患者白血病轉化率和死亡率分彆為25.2％(38/151)和43.7％(66/151),覈型異常者白血病轉化率和死亡率明顯高于覈型正常者(均P＜0.05).覈型異常者白血病轉化中位時間和生存中位時間均短于覈型正常者.漢族與維吾爾族MDS患者各亞型分佈、覈型異常特點及白血病轉化率、死亡率等方麵差異均無統計學意義(均P＞0.05).結論 染色體覈型異常在MDS不同亞型中存在差異且與預後密切相關,是影響MDS患者病情進展及預後的重要指標,對MDS的正確診斷、病情鑑測及預後評估有重要意義.
목적 탐토골수증생이상종합정(MDS)각아형중적염색체핵형분포특점급기여예후적관계.방법 회고분석151례원발성MDS환자적염색체핵형,비교각아형중적염색체핵형분포특점、국제예후적분계통(IPSS)평분、백혈병전화솔급사망솔등,병비교기재한족여유오이족MDS환자중유무민족차이성.결과 소유환자핵형이상검출솔위55.0％(83/151),기중간단이상점53.0％(44/83),복잡이상점47.0％(39/83).반다계병태조혈적난치성혈세포감소증(RCMD)、원시세포과다적난치성빈혈(RAEB)-Ⅰ、RAEB-Ⅱ아형중복잡이상적검출솔명현고우난치성빈혈(RA)、배형철립유세포증다적RA(RARS)아형.핵형이상섭급각조염색체,발생빈솔교고적염색체기변의차위-5/5q-、-7/7q-、+8、-20/20q-、-X/-Y、i(17q)、9p-/9q-、+21등.IPSS평분재각아형중차이유통계학의의(x2=117.802,P＜0.01);고위조적핵형이상검출솔명현고우저위조화중위조(균P＜0.05).수방151례환자백혈병전화솔화사망솔분별위25.2％(38/151)화43.7％(66/151),핵형이상자백혈병전화솔화사망솔명현고우핵형정상자(균P＜0.05).핵형이상자백혈병전화중위시간화생존중위시간균단우핵형정상자.한족여유오이족MDS환자각아형분포、핵형이상특점급백혈병전화솔、사망솔등방면차이균무통계학의의(균P＞0.05).결론 염색체핵형이상재MDS불동아형중존재차이차여예후밀절상관,시영향MDS환자병정진전급예후적중요지표,대MDS적정학진단、병정감측급예후평고유중요의의.
Objective To investigate the characteristics of chromosome kayotypes and the relationship between the prognosis and chromosome karyotypes in subtypes of myelodysplastic syndromes (MDS).Methods The study retrospectively analyzed the characteristics of chromosome karyotype of initially diagnosed 151 MDS patients and investigated the rate and time of leukemia transformation and mortality,IPSS score,and compare the ethnic differences of Han and Uyghurs.Results Abnormal karyotype detection rate was 55.0 ％ (83/151),including simple abnormalities was 53.0 ％ (44/83),complex abnormalities was 47.0％ (39/83).h showed that common abnormal karyotype include-5/5q-,-7/7q-,+8,-20/20q-,-X/-Y,i(17q),9p-/9q-,+21.IPSS score had differences among subtypes (x2 =117.802,P ＜ 0.01).The detection rates of abnormal chromosome had significantly differences between each group,the abnormal karyotype detection rate in high-risk group was significantly higher than those in low risk group and moderate group(P ＜ 0.05).Followup 31 months (5-68 months) and found that the rates of leukemia transformation and mortality were 25.2 ％ (38/151) and 43.7 ％ (66/151),the rates of leukemia transformation and mortality in abnormal karyotype group were significantly higher than those in normal karyotype group (P ＜ 0.05).The median survival time in abnormal karyotype was shorter than that in normal one.The distribution of Han and Uyghur patients with MDS subtypes,the characteristics of abnormal karyotype,the rates of leukemia transformation and the rates of mortality had no statistical difference (all P ＞ 0.05).Conclusion Abnormal chromosome karyotype is important index for disease progression and prognosis of MDS patients.
