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一项基于单中心人群的1500例接受细胞遗传学研究的成人血液系统恶性肿瘤连续病例系列研究:与形态学、年龄和性别的核型特征关系。

A single-center population-based consecutive series of 1500 cytogenetically investigated adult hematological malignancies: karyotypic features in relation to morphology, age and gender.

作者信息

Mauritzson N, Johansson B, Albin M, Billström R, Ahlgren T, Mikoczy Z, Nilsson P G, Hagmar L, Mitelman F

机构信息

Department of Internal Medicine, Lund University Hospital, Sweden.

出版信息

Eur J Haematol. 1999 Feb;62(2):95-102. doi: 10.1111/j.1600-0609.1999.tb01728.x.

Abstract

During the 18-yr period 1976-93, a population-based series of 1586 adults with suspected or confirmed hematological malignancies were successfully cytogenetically investigated at a single center. Eighty-six cases were excluded due to unretrievable medical records or if analyzed only in remission or at relapse. The remaining 1500 medical records were reviewed regarding morphology and clinical parameters in order to investigate possible associations between karyotypic pattern (normal, 1, 2 or complex anomalies; specific abnormalities) and gender, age and morphological subgroups. The impact of time-period, i.e. 1976-87 vs. 1988-93, and referring center on cytogenetic findings was also studied. A total of 372 acute myeloid leukemias (AML), 389 myelodysplastic syndromes (MDS), 64 acute lymphoblastic leukemias (ALL) and 262 chronic myeloid leukemias (CML) were identified, altogether 1087 cases. Patients with other (n=261) or no hematological malignancies (n = 152) were excluded from the present analysis. Cytogenetic abnormalities were detected in 52% AML, 51 % MDS, 68% ALL and 97% CML, frequencies that did not differ significantly between the 2 time periods or referring centers. No significant age- or gender-related differences in karyotypic patterns were discerned in AML, MDS, ALL or CML, whereas the karyotypic patterns varied among the FAB groups in both AML (p= 0.001) and MDS (p < 0.001). The specific abnormalities t(8;21), t(15;17) and inv(16) were more common (p < 0.001) in younger AML patients and 5q- was more frequent in females with MDS (p<0.001). These findings indicate, in contrast to previous series, that neoplasia-associated karyotypic aberrations are not more common among older patients or in males.

摘要

在1976年至1993年的18年期间,一个基于人群的系列研究对1586例疑似或确诊血液系统恶性肿瘤的成年人在单一中心成功进行了细胞遗传学研究。86例因无法获取病历记录或仅在缓解期或复发期进行分析而被排除。对其余1500份病历的形态学和临床参数进行了回顾,以研究核型模式(正常、1种、2种或复杂异常;特定异常)与性别、年龄和形态学亚组之间可能存在的关联。还研究了时间段(即1976 - 1987年与1988 - 1993年)和转诊中心对细胞遗传学结果的影响。共识别出372例急性髓系白血病(AML)、389例骨髓增生异常综合征(MDS)、64例急性淋巴细胞白血病(ALL)和262例慢性髓系白血病(CML),共计1087例。其他血液系统恶性肿瘤患者(n = 261)或无血液系统恶性肿瘤患者(n = 152)被排除在本分析之外。在AML患者中,52%检测到细胞遗传学异常;MDS患者中为51%;ALL患者中为68%;CML患者中为97%。这些频率在两个时间段或转诊中心之间无显著差异。在AML、MDS、ALL或CML中,未发现核型模式存在显著的年龄或性别相关差异,而在AML(p = 0.001)和MDS(p < 0.001)中,FAB组之间的核型模式各不相同。在年轻AML患者中,特定异常t(8;21)、t(15;17)和inv(16)更为常见(p < 0.001),而5q-在MDS女性患者中更为频繁(p < 0.001)。与之前的系列研究相比,这些发现表明,肿瘤相关的核型畸变在老年患者或男性中并不更常见。

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