肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
Cancer Research and Clinic
2015年
9期
593-596
,共4页
刘虹%王晓敏%李丹%张玥玥
劉虹%王曉敏%李丹%張玥玥
류홍%왕효민%리단%장모모
白血病,淋巴细胞,慢性%细胞遗传学%预后
白血病,淋巴細胞,慢性%細胞遺傳學%預後
백혈병,림파세포,만성%세포유전학%예후
Leukemia,lymphocytes,chronic%Cytogenetics%Prognosis
目的：探讨慢性淋巴细胞白血病（CLL）的染色体异常与疾病进展及预后的关系。方法对56例CLL患者行染色体核型分析，应用CLL组合探针进行荧光原位杂交（FISH）检测，分析染色体异常与疾病进展及预后的关系。结果常规细胞遗传学检测发现异常核型26例（46.4%），核型正常组中位总生存（OS）期（＞31.9个月）与异常组（24.0个月）比较，差异有统计学意义（χ2＝6.60，P＜0.05）。FISH检测发现基因异常38例（67.9%），异常检出率高于常规染色体检测组（χ2＝9.874，P＜0.01），其中RB1异常检出率为33.9%（19／56），D13S25为46.4%（26／56），ATM为16.1%（9／56），p53为12.5%（7／56）；累及1种基因异常21例，2种12例，3种4例，4种1例。按Rai改良分期标准，累及基因异常种类在低中危和高危组中分布差异有统计学意义（χ2＝11.77，P＜0.05）。 D13S25、RB1正常与异常者的中位OS期差异无统计学意义（P＞0.05）；p53、ATM异常者的中位OS期均短于正常者（P＜0.05）。累及4种基因异常者的中位OS期短于基因正常和累及1、2、3种异常者。按Rai分期标准，低中危组OS率高于高危组（χ2＝10.61，P＜0.05）；按Binet分期，C期OS率低于B期（χ2＝6.60，P＜0.05）。结论相同危险度CLL患者预后存在很强的异质性，细胞遗传学改变和生物学指标是CLL重要的预后预测因素。
目的：探討慢性淋巴細胞白血病（CLL）的染色體異常與疾病進展及預後的關繫。方法對56例CLL患者行染色體覈型分析，應用CLL組閤探針進行熒光原位雜交（FISH）檢測，分析染色體異常與疾病進展及預後的關繫。結果常規細胞遺傳學檢測髮現異常覈型26例（46.4%），覈型正常組中位總生存（OS）期（＞31.9箇月）與異常組（24.0箇月）比較，差異有統計學意義（χ2＝6.60，P＜0.05）。FISH檢測髮現基因異常38例（67.9%），異常檢齣率高于常規染色體檢測組（χ2＝9.874，P＜0.01），其中RB1異常檢齣率為33.9%（19／56），D13S25為46.4%（26／56），ATM為16.1%（9／56），p53為12.5%（7／56）；纍及1種基因異常21例，2種12例，3種4例，4種1例。按Rai改良分期標準，纍及基因異常種類在低中危和高危組中分佈差異有統計學意義（χ2＝11.77，P＜0.05）。 D13S25、RB1正常與異常者的中位OS期差異無統計學意義（P＞0.05）；p53、ATM異常者的中位OS期均短于正常者（P＜0.05）。纍及4種基因異常者的中位OS期短于基因正常和纍及1、2、3種異常者。按Rai分期標準，低中危組OS率高于高危組（χ2＝10.61，P＜0.05）；按Binet分期，C期OS率低于B期（χ2＝6.60，P＜0.05）。結論相同危險度CLL患者預後存在很彊的異質性，細胞遺傳學改變和生物學指標是CLL重要的預後預測因素。
목적：탐토만성림파세포백혈병（CLL）적염색체이상여질병진전급예후적관계。방법대56례CLL환자행염색체핵형분석，응용CLL조합탐침진행형광원위잡교（FISH）검측，분석염색체이상여질병진전급예후적관계。결과상규세포유전학검측발현이상핵형26례（46.4%），핵형정상조중위총생존（OS）기（＞31.9개월）여이상조（24.0개월）비교，차이유통계학의의（χ2＝6.60，P＜0.05）。FISH검측발현기인이상38례（67.9%），이상검출솔고우상규염색체검측조（χ2＝9.874，P＜0.01），기중RB1이상검출솔위33.9%（19／56），D13S25위46.4%（26／56），ATM위16.1%（9／56），p53위12.5%（7／56）；루급1충기인이상21례，2충12례，3충4례，4충1례。안Rai개량분기표준，루급기인이상충류재저중위화고위조중분포차이유통계학의의（χ2＝11.77，P＜0.05）。 D13S25、RB1정상여이상자적중위OS기차이무통계학의의（P＞0.05）；p53、ATM이상자적중위OS기균단우정상자（P＜0.05）。루급4충기인이상자적중위OS기단우기인정상화루급1、2、3충이상자。안Rai분기표준，저중위조OS솔고우고위조（χ2＝10.61，P＜0.05）；안Binet분기，C기OS솔저우B기（χ2＝6.60，P＜0.05）。결론상동위험도CLL환자예후존재흔강적이질성，세포유전학개변화생물학지표시CLL중요적예후예측인소。
Objective To discuss the relationship betwee n chromosome abnormalities and disease progress and prognosis in chronic lymphocytic leukemia (CLL). Methods The karyotype of 56 patients with CLL were analyzed, and combined probe was applied to do fluorescence in situ hybridization (FISH) detection. Results Conventional cytogenetics detection found abnormal karyotype in 26 cases (46.4 %), by comparing the median overall survival (OS), the normal karyotype group (>31.9 months) and abnormal group (24.0 months) had statistically difference (χ2=6.60, P<0.05). FISH detected genetic abnormality in 38 cases (67.9 %), whose abnormal detection rate was significantly higher than the conventional chromosome group (χ2=9.874, P<0.01), RB1 was 33.9%(19/56), D13S25 was 46.4%(26/56), ATM was 16.1%(9/56), p53 was 12.5 % (7/56). 21 cases involved 1 kind of genetic abnormality, 12 cases involved 2 kinds of genetic abnormalities, 4 cases involved 3 kinds of genetic abnormalities, 1 case involved 4 kinds of genetic abnormalities. According to the modified installment Rai, involving genetic abnormality species distribution in the low risk and high risk group had statistically difference (χ2 = 11.77, P< 0.05). The median OS of D13S25, RB1 normal and abnormal patients had no difference (P>0.05), the OS of patients with p53 or ATM gene abnormality was significantly shorter than that of normal patients. Compared with the patients without genetic abnormality and with 1, 2 or 3 kinds of gene abnormalities, the patients with 4 kinds of gene abnormalities had minimum median OS. According to the modified installment Rai, the OS rate of low and intermediate risk group was higher than that of low risk group (χ2= 10.61, P< 0.05). According to the modified installment Binet stage,the OS rate of stage C was lower than that of stage B (χ2= 6.60, P< 0.05). Conclusion The prognosis of CLL patients in same risk group is very strong heterogeneity, cytogenetics changes and biological indicator are the important prognostic factors of CLL.
