Kullendorff C M, Mertens F, Donnér M, Wiebe T, Akerman M, Mandahl N
Department of Pediatric Surgery, University Hospital, Lund, Sweden.
Med Pediatr Oncol. 1999 Feb;32(2):79-83. doi: 10.1002/(sici)1096-911x(199902)32:2<79::aid-mpo1>3.0.co;2-r.
Ewing sarcoma is associated with a nonrandom pattern of primary and secondary chromosomal aberrations. Whereas the finding of rearrangements of chromosome 22, usually in the form of a balanced translocation t(11;22)(q24;q12), is important diagnostically, nothing is known about the potential prognostic impact of the secondary chromosomal aberrations.
During a 1 3-year-period, short-term cultured tumor samples from 21 children and young adults with Ewing sarcoma were cytogenetically analyzed successfully.
Clonal chromosome aberrations were detected in 18 patients, 17 of whom had the characteristic t(11;22)(q24;q12) or variants thereof. The most frequent secondary change was +8, followed by +12, +2, +5, +9, +15, and gain of material from the long and short arms of chromosome 1. The only recurrent secondary change that was restricted to tumors from the ten patients that were dead at latest follow-up was gain of 1q material. Furthermore, all three patients with tumors with chromosome numbers over 50 had died, and the only patient with a tumor karyotype lacking chromosome 22 rearrangement was alive without evidence of disease.
These data and previously published results indicate that the karyotypic pattern not only may be of diagnostic significance but also may be important prognostically.
尤因肉瘤与原发性和继发性染色体畸变的非随机模式相关。虽然22号染色体重排的发现,通常以平衡易位t(11;22)(q24;q12)的形式,在诊断上很重要,但关于继发性染色体畸变的潜在预后影响却一无所知。
在13年期间,成功地对21例患有尤因肉瘤的儿童和年轻成人的短期培养肿瘤样本进行了细胞遗传学分析。
在18例患者中检测到克隆性染色体畸变,其中17例具有特征性的t(11;22)(q24;q12)或其变体。最常见的继发性改变是+8,其次是+12、+2、+5、+9、+15以及1号染色体长臂和短臂物质的增加。唯一局限于在最新随访时死亡的10例患者肿瘤中的复发性继发性改变是1q物质的增加。此外,所有3例染色体数超过50的肿瘤患者均已死亡,而唯一肿瘤核型缺乏22号染色体重排的患者存活且无疾病证据。
这些数据和先前发表的结果表明,核型模式不仅可能具有诊断意义,而且在预后方面可能也很重要。