Research and Development Department, Fleury Group, , Sao Paulo, Brazil.
J Clin Pathol. 2014 Feb;67(2):176-8. doi: 10.1136/jclinpath-2013-201822. Epub 2013 Aug 28.
Polycythaemia vera (PV), essential thrombocythemia (ET) and idiopathic myelofibrosis (MF), are the most common myeloproliferative neoplasms (MPN) in patients without the BCR-ABL1 gene rearrangement. They are caused by clonal expansion of haematopoietic stem cells and share, as a diagnostic criterion, the identification of JAK2V617F mutation. Classically, when other clinical criteria are present, a JAK2V617F negative case requires the analysis of Exon12_JAK2 for the diagnosis of PV, and of MPL515K/L mutations for the diagnosis of ET and MF. Here, we evaluated 78 samples from Brazilian patients suspected to have MPN, without stratification for PV, ET or MF. We found that 28 (35.9%) are JAK2V617F carriers; from the 50 remaining samples, one (2%) showed an Exon12_JAK2 mutation, and another (2%) was positive for MPLW515L mutation. In summary, the investigation of JAK2V617F, Exon12_JAK2 and MPLW515K/L was relevant for the diagnosis of 38.4% of patients suspected to have BCR-ABL1-negative MPN, suggesting that molecular genetic tests are useful for a quick and unequivocal diagnosis of MPN.
真性红细胞增多症(PV)、特发性血小板增多症(ET)和原发性骨髓纤维化(MF)是无 BCR-ABL1 基因重排患者中最常见的骨髓增殖性肿瘤(MPN)。它们是由造血干细胞的克隆性扩张引起的,作为诊断标准,共同识别 JAK2V617F 突变。经典情况下,当存在其他临床标准时,JAK2V617F 阴性病例需要分析 Exon12_JAK2 以诊断 PV,分析 MPL515K/L 突变以诊断 ET 和 MF。在这里,我们评估了 78 例来自巴西疑似患有 MPN 的患者样本,未对 PV、ET 或 MF 进行分层。我们发现 28 例(35.9%)为 JAK2V617F 携带者;在剩余的 50 个样本中,有 1 例(2%)显示 Exon12_JAK2 突变,另 1 例(2%)MPLW515L 突变阳性。总之,JAK2V617F、Exon12_JAK2 和 MPLW515K/L 的调查对诊断疑似 BCR-ABL1 阴性 MPN 的 38.4%患者具有重要意义,表明分子遗传学检测对 MPN 的快速和明确诊断是有用的。