摘要
目的分析急性淋巴细胞白血病(ALL)患者免疫表型、染色体和分子遗传学异常。方法选择2014年1月至2015年1月于焦作市第二人民医院收治的139例ALL患者为研究对象,按年龄将患者分为儿童组(≤14岁,n=57)和成人组(>14岁,n=82)。检测并分析患者的免疫表型、染色体核型及分子遗传学特征;所有患者随访5 a,记录患者完全缓解(CR)、复发、总生存期(OS)、中位OS等。采用Cox模型分析ALL患者复发、死亡风险的影响因素,采用Kaplan-Meier法绘制生存曲线,采用log-rank检验进行生存分析。结果139例ALL患者均进行免疫表型检查,其中急性B淋巴细胞白血病(B-ALL)患者115例(82.74%),急性T淋巴细胞白血病(T-ALL)患者18例(12.96%),非T非B细胞型急性淋巴细胞白血病(N-ALL)3例(2.15%),T/B双表达急性淋巴细胞白血病(急性混合型)3例(2.15%)。成人组与儿童组患者的免疫表型比较差异无统计学意义(P>0.05)。T-ALL患者的干/祖细胞标志CD34、人白细胞DR抗原(HLA-DR)阳性率明显低于B-ALL患者(P<0.05)。Kaplan-Meier分析显示,含有脯氨酸合成途径必须的基因B(pro-B)型患者的中位OS未达到,普通B细胞(com-B)型、前B细胞(pre-B)型、T-ALL患者的中位OS分别为41、45、22个月;log-rank检验显示,T-ALL患者的中位OS显著短于com-B型、pre-B型患者(P<0.05)。139例ALL患者均进行染色体核型分析,其中正常核型72例(51.80%),异常核型67例(48.20%)。成人组患者中正常核型34例(41.46%),异常核型48例(58.54%);儿童组患者中正常核型38例(66.67%),异常核型19例(33.33%);儿童组患者异常核型比例显著低于成人组(P<0.05)。儿童组和成人组t(9;22)核型患者分别占3.51%(2/57)、21.95%(18/82),儿童组和成人组t(8;14)核型患者分别占0.00%(0/57)、7.37%(6/82),儿童组t(9;22)、t(8;14)核型患者比例显著低于成人组(P<0.05)。Kaplan-Meier分析显示,正常核型患者的中位OS未达到,t(9;22)、亚二倍体、复杂核型及其他类�
Objective To analyze the immunophenotype,chromosomal and molecular genetic abnormalities in adults and children with acute lymphoblastic leukemia(ALL).Methods A total of 139 ALL patients treated in the Second People′s Hospital of Jiaozuo City from January 2014 to January 2015 were selected as the research subjects,and the patients were divided into children group(≤14 years old,n=57)and adult group(>14 years old,n=82).The immunophenotype,chromosome karyotype and molecular genetic characteristics of the patients were detected and analyzed.All patients were followed up for 5 years,and the complete remission(CR),recurrence,overall survival(OS)and median OS were recorded.The influencing factors of recurrence and death of ALL patients were analyzed by Cox model.The survival curves were drawn by Kaplan-Meier method and the survival analysis was performed by log-rank test.Results The immunophenotype detection was performed in the 139 patients with ALL,including 115(82.74%)patients with acute B-lymphoblastic leukemia(B-ALL),18(12.96%)patients with acute T-lymphoblastic leukemia(T-ALL),3(2.15%)patients with null acute lymphocytic leukemia(N-ALL)and 3(2.15%)patients with T/B double expression acute lymphoblastic leukemia(acute mixed type).There was no significant difference in immunophenotype between adult group and children group(P>0.05).The positive rates of stem/progenitor cell marker CD34 and human leukocyte antigen DR(HLA-DR)in patients with T-ALL were significantly lower than those in patients with B-ALL(P<0.05).Kaplan Meier analysis showed that the median OS of patients with common B cell(com-B),pre-B cell(pre-B)and T-ALL was 41,45 and 22 months,respectively;but the median OS of patients with gene B containing the proline(pro-B)was not reached.Log-rank test showed that the median OS of patients with T-ALL was significantly shorter than that of patients with com-B and pre-B(P<0.05).The chromosome karyotypes of 139 patients with ALL were analyzed,including 72 cases of normal karyotype(51.80%)and 67 cases of abnorma
作者
张军伟
ZHANG Junwei(Department of Clinical Laboratory,the Second People's Hospital of Jiaozuo City,Jiaozuo 454000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2022年第1期60-66,共7页
Journal of Xinxiang Medical University
