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目的对急性非淋巴细胞白血病的形态学和细胞遗传学分型进行综合分析、比较。方法对169例初次诊断为急性非淋巴细胞白血病的患者抽骨髓进行形态学检查,常规染色分类,同时进行细胞化学染色,包括过氧化物酶、糖原染色、A-醋酸奈酚酯酶及氟化钠抑制等试验。按FAB标准对急性非淋巴细胞白血病进行分型。骨髓染色体检查,采用24小时培养法或直接培养法。常规低渗,固定,行G或R显带,进行染色体分析。每例分析10～30个中期分裂相。异常克隆根据人类染色体国际命名体制(ISSN,1985年)的标准命名核型。结果在169例患者中,69.2%的患者有染色体异常改变,其中结构异常占35.5%,数目异常占33.7%,M2、M3、M5、M4畸变比率较高,分别为27.8%、24.3%、7.1%、3.6%,占染色体畸变总数的90.8%,M1、M6次之,M0、M7较少有染色体畸变。染色体结构异常以t(8;21)、t(15;17)、inv(16)畸变最多。t(8;21)在M2畸变核型中检出率为92.0%,t(15;17)在M3畸变核型中检出率为92.9%,inv(16)在M4畸变核型中检出率为66.7%。结论对急性非淋巴细胞白血病的细胞遗传学与形态学分型间的关系作了探讨,表明形态学和细胞遗传学是一个不可分割的整体。
Objective To analyze and compare the morphological and cytogenetic typing of acute non-lymphocytic leukemia. Methods A total of 169 patients with acute non-lymphocytic leukemia who were initially diagnosed as acute non-lymphocytic leukemia were examined by morphological examination and routinely stained for classification. Cytochemical staining including peroxidase, glycogen, A-acetate acetate esterase and fluorine Sodium inhibition and other tests. Acute non-lymphocytic leukemia was typed according to FAB criteria. Bone marrow chromosome examination, using 24-hour culture or direct culture. Conventional hypotonic, fixed, line G or R banding, chromosome analysis. Each case analyzed 10 to 30 metaphase. Abnormal clones are named according to the standard of the International Nomenclature System for Human Chromosomes (ISSN, 1985). Results Of the 169 patients, 69.2% had chromosomal abnormalities, of which 35.5% were structural abnormalities and 33.7% were abnormal. The rates of M2, M3, M5 and M4 aberrations were high, which were 27.8%, 24.3% and 7.1% %, 3.6%, accounting for 90.8% of the total number of chromosome aberrations, followed by M1 and M6, while M0 and M7 have less chromosomal aberrations. Chromosome structural abnormalities to t (8; 21), t (15; 17), inv (16) the most distorted. The detection rate of t (8; 21) was 92.0% in M2 aberrant karyotype, and that of t (15; 17) was 92.9% in M3 karyotype. The inv (16) The rate was 66.7%. Conclusion The relationship between cytogenetics and morphologic classification of acute non-lymphocytic leukemia is explored, indicating that morphology and cytogenetics are an indivisible whole.