摘要
目的:分析67例急性髓细胞白血病（AML）M2b型病人的临床特征。方法:以细胞形态学为基础,结合细胞遗传学、分子生物学等方法检查AML M2b型病人的骨髓标本。结果:在67例病人骨髓片中,异常中幼粒细胞的特征性形态变化主要表现为核浆发育不平衡,占6％～66％,其中有5例<10％。57例作染色体检查均发现t（8;21）（q22;q22）。34例进行融合基因检测,均发现急性髓细胞白血病21号染色体的1基因和8号染色体的EithtTwenty-One基因交互易位形成融合基因（AML1-ETO）。结论:①染色体t（8;21）与M2b密切相关,且常伴性染色体的丢失,尤以Y染色体丢失常见。②AML1-ETO融合基因可作为M2b亚型的分子标志物,同时对判断预后和监测残留白血病等方面也有一定价值。③异常中幼粒的特征性形态改变是细胞形态学分类的关键,而其数量不一定>30％。
Objective: To analyze the clinical features of 67 cases of subtype M2b acute myelocytic leukemia(AML-M2b). Methods: Medullary specimens of patients with AML-M2b were analyzed by cytomorphology, cytogenetics and molecular biology. Results: In the specimens of 67 cases of AML-M2b, the abnormal myelocytes with specific morphological changes mainly manifested as hypogenesis of nucleplasm were 6%-66% , and 5 cases of them were less than 10%.57 cases underwent the test of chromosome and all of them were detected t(8;21) (q22;q22). 34 cases underwent the test of fusion gene, and crossing translocation forming fusion gene AML1-ETO was found between the first gene located on No. 21 chromosome and Eight Twenty-One gene located on No. 8 chromosome in patients with AML. Conclusions: t(8;21) chromosome was closely related to M2b, and it was also lost with idiochromo-some, especially in chromosome Y. AML1-ETO fusion gene can not only be regarded as a molecular marker of acute myelocytic leukemia subtype M2b, but also is helpful in evaluating prognosis and monitoring remant leukemia. The key of the cytomorphological classification of abnormal myelocytes is its specific morphological changes, but its amount is not always more than 30%.
出处
《诊断学理论与实践》
2002年第2期88-89,共2页
Journal of Diagnostics Concepts & Practice
