| 袁翠英周敏谢品浩张谦董海波陈兰昕欧阳建△.慢性髓细胞白血病急变期MICM 分型回顾性分析[J].,2011,11(19):3645-3647 |
| 慢性髓细胞白血病急变期MICM 分型回顾性分析 |
| Analysis of Morphology, Immunology, Cytogentic and Molecular BiologyClassification of Patients with Chronic Myeloid Leukemia in Blastic Crisis |
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| DOI： |
| 中文关键词: 慢性髓细胞白血病 急变 MICM 分型 |
| 英文关键词: Chronic myeloid leukemia Blastic crisis MICM analysis |
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| 中文摘要: |
| 目的：探讨慢性髓细胞白血病急变期(CML-BC) 患者的细胞形态学（M）、免疫学（I）、细胞遗传学（C）和分子生物学（M）的特
征及应用价值。方法：对38 例CML-BC 患者的MICM 分型进行回顾性分析。结果：以FAB 分型为基础的形态学确诊率达94.7%；
免疫分型结果为：38 例CML-BC 中CML-AML 占71.0％，其中37.0%伴淋系表达；CML-ALL 占23.7％，均为B 细胞性，其中
66.67%伴髓系表达；CML-MAL(混合性白血病)占5.3%，均为B 系和髓系混合表达；CD34+26 例(68.4%)，CD7+10 例(26.3%)，均与
CD34 共表达。细胞遗传学结果显示：CML 特征性Ph 染色体检出率为94.3%(36/38)，附加异常染色体检出率为60.5%（23/38），发
生频率较高的类型是+Ph、+8 和i(17q)；FISH 检测BCR /ABL 融合基因阳性率为100%，der(9)缺失占14.7%。RT-PCR 检测20 例
患者BCR /ABL 融合基因均为阳性，其中b2a2 型(12/20)，b3a2 型(8/20)，1 例(1/20)，b2a2 和b3a2 双阳性(1/20)。结论：CML-BC 是
造血干细胞疾病，原始细胞分化阻滞在早期阶段，预后差。MICM 分型对CML-BC 的诊断、治疗和预后判断均有重要价值。 |
| 英文摘要: |
| Objective: To invistigate the characteristic and value of bone marrow morphology, immunology, cytogenetic and
molecular biology (MICM) in patients with chronic myeloid leukemia in blastic crisis (CML-BC). Methods: 38 patients with CML-BC
were studied by MICM analysis. Results: The accuracy rate of morphological diagonis based on FBA classification was 94.7%. Immunology
results, the percentage of CML-AMLwas 71.0%, in which 37.0% patients expressed lympholytic associated antigen; The percentage
of CML-ALL was 23.7% and all were B lypholytic immunophenotype, in which 66.7% patients expressed myeloid assuiated antigen; The
percentage of CML-MALwas 5.3% with all expressing B lypholoid and myeloid immumphenotype. 26 cases (68.4%) had CD34 expression
and 10 cases (26.3%) had CD7 and CD34 Co-expression. In cytogenetic result, the positive rate of Ph chromosome was 94.3%. Other
chromosome abnomality rate was 60.5% with +ph,+8 and i (17q) in high appearance rate. The positive rate of BCR /ABL gene by
FISH reached 100% with 14.7% del(9). The positive rate of BCR /ABLgene by RT-PCR also reached 100% with b2a3(12/20),b3a2(8/20)
and b2a3+b3a2(1/20). Conclusion: CML-BC is a kind of disease of stem cell. The differentiation of blast cell is blocked in the early stage.
MICM has great value in diangnosis, therapy and prognosis judgement. |
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