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本研究对566例成人急性淋巴细胞白血病(aALL)和586例儿童急性淋巴细胞白血病(cALL)的细胞遗传学进行对比分析。对所有患者均进行了细胞遗传学分析,部分患者进行了FISH检测。结果表明:aALL与cALL的染色体异常存在明显的差异。aALL中异常核型占62.0%,染色体异常较多见的为t(9;22)(q34;q11)、亚二倍体、超二倍体(47-50)、abn(6q)、abn(9p)、-7等,预后不良的占多数。cALL中异常核型占39.2%,染色体异常较多见的为高超二倍体、亚二倍体、TEL/AML1(+)、+8、超二倍体(47-50)、+21等,预后良好的占多数。其中异常核型、总亚二倍体、总超二倍体(47-50)、t(9;22)(q34;q11)、-7、abn(7q)、abn(14q32)、+Ph在aALL中的发生率明显高于cALL;cALL正常核型(N)、高超二倍体、+8、+21*2、TEL/AML1(+)的发生率明显高于aALL。Ph(+)在aALL中的检出率为20.5%,伴有附加异常的占63.8%。Ph(+)aALL附加异常中+Ph、-7、i(9q+)、9p-、+8、+21、+X、6q-、abn(14q32)、+14出现的比例较高。Ph(+)在cALL中的检出率为4.4%,明显低于aALL(p=0.000),伴有附加异常的占42.3%,附加异常中abn(9p)、abn(7p)、-7、17p-、+21出现的比例较高。结论:本组病例染色体数目异常及结构异常几乎涉及到每一条染色体,复杂核型多见。aALL与cALL的染色体异常存在明显的差异。
This study compared the cytogenetics of 566 adult patients with acute lymphocytic leukemia (aALL) and 586 children with acute lymphoblastic leukemia (cALL). All patients underwent cytogenetic analysis, and some patients underwent FISH. The results showed that: aALL and cALL chromosomal abnormalities there are significant differences. The aberrant karyotype in aALL accounted for 62.0%. The most common chromosomal abnormalities were t (9; 22) (q34; q11), subdiploid, diploid (47-50), abn 9p), - 7, poor prognosis accounted for the majority. The abnormal karyotype in cALL accounted for 39.2%. The most common chromosomal abnormalities were diploid, sub-diploid, TEL / AML1 (+), +8, diploid (47-50) The prognosis is good for the majority. Among them, the abnormal karyotype, total sub-diploid, total diploid (47-50), t (9,22) (q34; q11), -7, abn (7q), abn The incidence of aALL was significantly higher than that of cALL. The incidence of TEL / AML1 (+) was significantly higher than that of aALL in cALL normal (N), diploid, +8, +21 * 2. The detection rate of Ph (+) in aALL was 20.5%, with additional abnormalities accounting for 63.8%. Ph + + aALL additional abnormalities + Ph, -7, i (9q +), 9p-, +8, +21, + X, 6q-, abn (14q32), +14 appear higher proportion. The detection rate of Ph (+) in cALL was 4.4%, significantly lower than aALL (p = 0.000), with additional abnormalities accounting for 42.3%, additional abnormalities abn (9p), abn 17p -, + 21 appears higher proportion. Conclusion: The number of chromosomal abnormalities and structural abnormalities in this group are involved in almost every chromosome, complex karyotype more common. There was a clear difference in chromosomal abnormalities between aALL and cALL.