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骨髓增殖性肿瘤和骨髓增生异常/骨髓增殖性肿瘤中 JAK2 突变状态与细胞遗传学异常的相关性。

Association of JAK2 mutation status and cytogenetic abnormalities in myeloproliferative neoplasms and myelodysplastic/myeloproliferative neoplasms.

机构信息

Department of Pathology, Oregon Health & Science University, Portland, USA.

出版信息

Am J Clin Pathol. 2011 May;135(5):709-19. doi: 10.1309/AJCPS6C8EVYCQNRM.

Abstract

Myeloproliferative neoplasms and myelodysplastic/myeloproliferative neoplasms are heterogeneous disorders. JAK2 mutation testing and karyotyping are routinely used for diagnosis but have not been incorporated into risk stratification in Philadelphia chromosome-negative myeloproliferative neoplasms. This study correlated cytogenetic abnormalities with disease stage and JAK2 status. A total of 179 cases were analyzed for the JAK2 mutation. Among them, cytogenetic data were available for 97 cases-45 of 106 JAK2+ and 52 of 73 JAK2-. The JAK2+ group showed a higher frequency of cytogenetic anomalies than the JAK2- group (23/45 [51%] vs 14/52 [27%]). Chromosome 9, chromosome 7, and 20q- were recurrent abnormalities in the JAK2+ group, whereas 13q- and trisomy 21 were common in the JAK2- group. In the JAK2+ group, chromosome 7 and complex cytogenetic abnormalities were associated with excess blasts/blastic transformation (P < .05), whereas no cases with 20q- underwent blastic transformation. Our results suggest that incorporation of JAK2 mutation testing and karyotyping allows for monitoring of disease progression with prognostic and therapeutic implications.

摘要

骨髓增殖性肿瘤和骨髓增生异常/骨髓增殖性肿瘤是异质性疾病。JAK2 基因突变检测和核型分析通常用于诊断,但尚未纳入费城染色体阴性骨髓增殖性肿瘤的风险分层。本研究将细胞遗传学异常与疾病分期和 JAK2 状态相关联。对 179 例进行了 JAK2 突变分析。其中,97 例有细胞遗传学数据,包括 106 例 JAK2+中的 45 例和 73 例 JAK2-中的 52 例。JAK2+组的细胞遗传学异常频率高于 JAK2-组(23/45 [51%] vs 14/52 [27%])。染色体 9、7 和 20q-是 JAK2+组中的常见异常,而 13q-和 21 三体是 JAK2-组中的常见异常。在 JAK2+组中,7 号染色体和复杂细胞遗传学异常与过度原始细胞/原始细胞转化有关(P <.05),而没有 20q-的病例发生原始细胞转化。我们的结果表明,JAK2 基因突变检测和核型分析的结合可用于监测疾病进展,具有预后和治疗意义。

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