To Diagnose The CML With CC And FISH Technology And Study The Deletion Of Derivative Chromosome 9 In CML Patients

Objective:Use the CC and FISH to diagnosis the CML and deletion of derivate chromosome 9,to evaluate the merit and demerit of the ES/DCDF/LSI 9q34 probe,and to investigate the clinical value of these technology.Methods:1. The bone marrow cell of patients were observed using wright's stain and such cytochemical techniques,and make morphological classification.2. Cytogenetic analysis was performed by 24h unstimulated culture, GTG banding and karyotype.3. Use the ES probe and DCDF probe to detect the fusion gene of all the patients.4. Detect all the patients with LSI 9q34 probe in order to know if they have the deletion of derivative chromosome 9.Result:1. The cytogenetic was analyzed in 41 patients of 98 patients.There are 38 patients have the typical t(9;22),1 patient has the normal karyotype,2 patients have not the karoytype.2. All of the patients were approved have the BCR-ABL fusion gene when detected with ES/DCDF probe. The patient who has the normal karyotype also has the BCR-ABL fusion gene ,was deemed to dormant translocation. The coincidence rate of CC and FISH is 97.4%.3. There are 6 patients were variant Phidephia translocation, the proportion is 15.38%, and 2 of them are AP. No deletion of derivative chromosome 9 patient was detected in these people. The probability of deletion of derivative chromosome 9 are equal in variant Phidephia and typical translocation ,and has no statistical meaning. There are 9 patients had additive cytogenetic abnormalities, the proportion is 23.68%, and 6 of them are AP or BP, 5 of them had the deletion of derivative chromosome 9. The probability of deletion of derivative chromosome 9 is higher in the patients who had the additive cytogenetic abnormalities than those had not,and higher in the patients who were in AP or BP than those in CP, has statistical meaning.4. All the 98 patients were detected by ES/DCDF probe ,and 22 patients had the deletion of derivative 9. In the patients who were detetected by LSI 9q34 probe ,21 patients had the deletion of derivative chromosome 9.Conclusion:1. The conventional cytogenetics can't diagnose the patients who had deletion of derivative chromosome 9. Use the FISH technology can fetch up this pity.2. Use the ES probe can't detect the variant phildephia translocation, use the DCDF probe can't detect which kinds of cariant phildephia translocation. These pity can fetch up by conventional cytogenetics.3. The proportion of deletion of derivative chromosome 9 is different between whose use the ES/DCDF probe and LSI 9q34 probe. We advise all the CML patients should use the LSI 9q34 probe to detect the deletion of derivative chromosome 9.4. The probability of deletion of derivative chromosome 9 is higher in the patients who had the additive cytogenetic abnormalities than those had not,and higher in the patients who were in AP or BP than those in CP.5. Use the ES probe can't estimate whether the patient has the deletion of derivative chromosome 9. Different signal can denote different deletion part of derivative chromosome 9. The prognosis of patient who has the ABL part deletion is worse.