摘要
目的 验证骨髓细胞姐妹染色单体分化 (SCD)检测法在骨髓增生异常综合征 (MDS)诊断和预后判断中的意义。方法 对临床上疑为MDS的 50例患者分别进行 5′溴脱氧尿嘧啶核苷 姐妹染色单体分化染色法 (BrdU SCD)检测和染色体核型分析。结果 50例中 32例 (64 0 % )SCD延迟 ,对照组中 1 3例急性髓系白血病 (AML)患者全部延迟 ,非恶性血液病中仅 2例 (1 0 5 % )延迟 ,而 4例正常人中无一例延迟。MDS与AML、正常人、再生障碍性贫血 (AA)、其他良性增生性贫血之间的SCD延迟率及平均细胞周期时间的差异具有显著性 ;而正常人与AA、其他良性增生性贫血之间的差异无显著性。随着MDS病情进展 ,细胞周期时间逐渐延长。 50例中 2 4例 (48 0 % )检出克隆性核型改变。按FAB分型不能确诊为MDS 7例中 6例有克隆性异常。SCD正常组和延迟组的病死率分别为 1 1 8%和50 0 % (P <0 0 5) ,白血病转化率分别为 5 9%和 1 6 7% (P >0 0 5) ,中位生存时间分别为 1 2和 8个月(P =0 0 51 )。
Objective To verify the value of sister chromatid differentiation (SCD) analysis of bone marrow cells in establishing the diagnosis and predicting prognosis of myelodysplastic syndrome (MDS) Methods S bromodeox yuridine SCD and karyotyping studies were performed in 50 cases with clinically suspected MDS Results Prolonged cell cycle time (CT) was found in 33 of the 50 cases (66 0%) In 13 cases with acute myeloid leukemia (AML) , all had prolonged CT However, only 2 (10 5%) of the 19 cases with nonmalignant hematological disorders had prolonged CT There were significant differences of CT between the cases with MDS and those with AML, aplastic anemia (AA) and benign hypercellular anemias as well as healthy individuals However, there were no significant differences between healthy individuals and cases with AA and, with benign hepercellular anemia CT gradually prolonged during the evolution of MDS 24 of the 50 patients (48 0%) were found to have clonal chromosomal abnormalities In seven cases not compatible with MDS according to FAB criteria, six were found to have clonal chromosomal abnormalities The mortality rates were 11 8 and 50 0% in the groups of normal SCD and of prolonged SCD, respectively ( P <0 05) The rates of leukemia transformation in both the groups were 5 9% and 16 7% ( P >0 05) The median survival of both the groups was 12 months and 8 months ( P =0 051) Conclusion SCD analysis is valuable for establishing the diagnosis and predicting the prognosis of MDS
出处
《中华内科杂志》
CAS
CSCD
北大核心
2002年第9期602-604,共3页
Chinese Journal of Internal Medicine
