Department of Pathology, Vancouver General Hospital, Canada.
Am J Clin Pathol. 2010 Jul;134(1):119-26. doi: 10.1309/AJCPH27ZIZEJLORF.
The diagnosis of myelodysplastic syndromes (MDSs) relies largely on morphologic and karyotypic abnormalities, present in about 50% of patients with MDS. Array-based genomic platforms have identified copy number alterations in 50% to 70% of bone marrow samples of patients with MDS with a normal karyotype, suggesting a diagnostic role for these platforms. We investigated whether blood granulocytes harbor the same copy number alterations as the marrow of affected patients. Of 11 patients, 4 had cytogenetic abnormalities shown by conventional karyotyping involving chromosomes 5, 8, 11, 20, and X, and these changes were seen in the granulocytes of all 4 patients by using array comparative genomic hybridization (aCGH). Cryptic alterations were identified at a significantly higher level in marrow CD34+ cells compared with granulocytes (P < .0001). These data suggest that aCGH analysis of circulating granulocytes may be useful in detecting gross karyotypic alterations in patients with MDS when marrow examination has failed or not been done.
骨髓增生异常综合征(MDS)的诊断主要依赖于形态学和细胞遗传学异常,约 50%的 MDS 患者存在这些异常。基于阵列的基因组平台已经在 50%至 70%核型正常的 MDS 患者的骨髓样本中发现了拷贝数改变,这表明这些平台具有诊断作用。我们研究了血液中的粒细胞是否存在与受影响患者骨髓相同的拷贝数改变。在 11 名患者中,有 4 名患者的核型异常通过常规核型分析显示涉及染色体 5、8、11、20 和 X,通过使用阵列比较基因组杂交(aCGH),所有 4 名患者的粒细胞均显示出这些变化。与粒细胞相比,骨髓 CD34+细胞中隐匿性改变的发生率显著更高(P<0.0001)。这些数据表明,当骨髓检查失败或未进行时,循环粒细胞的 aCGH 分析可能有助于检测 MDS 患者的大体核型改变。