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真性红细胞增多症中JAK2V617F突变及白细胞增多与血栓形成事件的关联

The association of JAK2V617F mutation and leukocytosis with thrombotic events in essential thrombocythemia.

作者信息

Hsiao Hui-Hua, Yang Ming-Yu, Liu Yi-Chang, Lee Ching-Ping, Yang Wen-Chi, Liu Ta-Chih, Chang Chao-Sung, Lin Sheng-Fung

机构信息

Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Exp Hematol. 2007 Nov;35(11):1704-7. doi: 10.1016/j.exphem.2007.08.011. Epub 2007 Oct 17.

Abstract

OBJECTIVES

The Janus kinase 2 mutation, JAK2 (V617F), and megakaryocytic mutations, MPL (W515L/K), have been identified and correlated with a subtype of essential thrombocythemia (ET) patients. We investigated the frequency of mutations in ET patients and analyzed the relationship with their clinical features.

METHODS

Fifty-three ET patients were enrolled in the study. The amplification refractory mutation system was applied for the mutation survey of the JAK2V617F, while the polymerase chain reaction with sequencing was used for the mutation survey of MPLW515L/K.

RESULTS

Thirty-five (66%) patients harboring the JAK2 (V617F) mutation, including 3 homozygous and 32 heterozygous changes, but no MPLW515L/K mutation, were found. During follow-up, 17 (32.1%) patients suffered from documented thrombotic events, with 15 having JAK2V617F mutations. Statistical analysis showed that patients with the JAK2 mutation had significantly higher leukocytes, hemoglobin level, and thrombotic event (p = 0.043, p = 0.001, and p = 0.029, respectively). Thrombotic events were also significantly correlated with leukocytosis and older age.

CONCLUSIONS

The JAK2V617F mutation was noted in a certain population of ET patients and correlated with leukocytosis, high hemoglobin level, and thrombosis. Therefore, detection of the JAK2V617F mutation can affect not only the diagnosis, but also the management of ET patients.

摘要

目的

已鉴定出Janus激酶2突变JAK2(V617F)和巨核细胞系突变MPL(W515L/K),并发现它们与原发性血小板增多症(ET)患者的一个亚型相关。我们调查了ET患者中这些突变的发生率,并分析了其与临床特征的关系。

方法

53例ET患者纳入本研究。采用扩增阻滞突变系统对JAK2V617F进行突变检测,而采用聚合酶链反应测序法对MPLW515L/K进行突变检测。

结果

发现35例(66%)患者存在JAK2(V617F)突变,包括3例纯合突变和32例杂合突变,但未发现MPLW515L/K突变。随访期间,17例(32.1%)患者发生了有记录的血栓事件,其中15例有JAK2V617F突变。统计学分析显示,JAK2突变患者的白细胞、血红蛋白水平及血栓事件发生率显著更高(p值分别为0.043、0.001和0.029)。血栓事件也与白细胞增多和年龄较大显著相关。

结论

在一定比例的ET患者中发现了JAK2V617F突变,且该突变与白细胞增多、高血红蛋白水平及血栓形成相关。因此,检测JAK2V617F突变不仅会影响ET患者的诊断,还会影响其治疗管理。

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