| Objective:Investigation of karyotype characteristic features of chromosome in hematology patients and its application in clinical practice, through the analysis of 866 samples of leukemia patients'chromosome data in our hospital.Methods:866 samples of bone marrow chromosome karyotype were collected and analysed from the hematological outpatient department and as well as hospitalized patients of our hospital from November 2003 until February 2011. All the specimens collected were from bone marrow. After having 24-hour cultured the bone marrow samples , the chromosome karyotypes were analysed by heat Giemsa R-banding techniques and the abnormal karyotypes were isolated and marked according to the << International system of human cytogenetics named (ISCN1991) >> .Results:1. 866 cases of leukemia patients (out of which 701 cases were preliminary diagnosed), 354 of them were female(302 cases with preliminary diagnosed), and 512 male patients (399 were preliminary diagnosed).The age ranged from 18 months to 90 years, with median age of 49 years old. chromosome analysis was performed once for 716 patients and for 81 patients the examination was done 2-9 times. Abnormal chromosome karyotype was detected in 524 patients out of the 866 leukemia cases, the abnormal karyotype rate was 60.51%(524/866). Out of the 701 cases of preliminary diagnosed leukemia patients, 435 had abnormal karyotype, and the incidence of chromosomal abnormalities was 62.05% (435/701). 69 of the 866 patients were juvenile (with 61 preliminary diagnosed),and the rest were 797 adult patients (with 640 of them had preliminary diagnosis).2. Abnormal karyotype was detected in 201 cases out of the 340 patients who had preliminary diagnosis of acute non-lymphocytic leukemia (ANLL), the occurence rate was 59.12%. 52 patients from the 112 cases of acute lymphoblastic leukemia (ALL) were found to have abnormal karyotypes, the incidence being 46.43%. From 167 patients with chronic myeloid leukemia (CML),abnormal karyotypes was detected in 163 patients, with a rate of 97.60%. 14 patients of 60 cases of chronic lymphocytic leukemia (CLL) showed nuclear abnormalities, with a rate of 23.33%; In 22 patients with chronic myelogenous - monocytic leukemia (CMML), 5 cases had abnormal chromosome, incidence being 22.73%. Henceforth, the rate of abnormal karyotype detection in preliminary diagnosed ANLL subtypes M1, M2, M3, M4, M5, M6 were 28.57%(2/7), 50.0%(64/128), 95.45%(84/88), 34.48%(10/29), 45.12%(37/82) and 66.67%(4/6) respectively. 30 cases of ANLL-M3 patients were further examined , and 6 cases of them were found to have t(15; 17), the rate was 20%; Abnormal karyotype were checked out from 70 patients out of the 107 after further examination of CML patients, thus showing an incidence of 65.42%; However, chromosome mutation occurred in 4 patients after treatment. Whereas 3 patients with ANLL were unclassified, with 1 case having abnormal karyotype. Within 61 cases from the minor groups, 40 showed abnormal karyotype, the detection rate being 65.57%; 640 cases of adult group with 395 cases of abnormal karyotype, the detection rate was 61.72%. 176 cases with abnormal karyotype were detected from 302 preliminary diagnosis female patients, the rate was 58.28%;399 preliminary diagnosis male patients found 259 cases had abnormal karyotype,the rate was 64.91%.3. Chi-square test was performed ,which showed no statistical significance(P>0.05) in the group : the subtypes of ANLL(excepted M3), minors and adult, female and male. There was significant difference in the abnormal karyotype detection rates between preliminary diagnosis of M3 and further consultation with hematology ease cases, preliminary diagnosis of CML and further consultation CML, had statistically significant(P=0.00).4,In 866 cases of leukemia, 2 patients were diagnosed rely on chromosome examination. One patients suspected as CMML, by chromosome-specific genetic examination revealed t (9; 22) anomaly diagnosed CML, the other patient suspected leukemia as class leukemia reaction, by chromosome exist t (9; 22) and diagnosed CML. 4 cases of patients suspected M3 exist Chromosome t (15; 17), diagnosed as M3.Conclusion:1. R banding technique applied in newly diagnosed patients with acute leukemia patiens can be detected in 55.97% of chromosomal abnormalities. ANLL-M3 abnormality was 95.45% . Newly diagnosed chronic leukemia patients karyotype detection rate were73.09%, including CML anomaly detection rate 97.6%,and main of them werespecific chromosomal rearrangement . They are related to specific FAB subtypes, therefore Karyotype analysis is an important indicatorof diagnosis and classification of leukemia. Frequency abnormalities of chromosome were not related to age and gender.2. Parts of the nuclear abnormalities were associated with specific FAB subtypes.Such as: t (15; 17) chromosomal mutation found only in M3-type acute myeloid leukemia, t (8; 21) abnormalities were mainly observed in acute myeloid leukemia type M2. The t (9; 22) were an important condition of diagnosed as chronic myeloid leukemia.3. Morphocytology is still the most direct and most important means of economic diagnosis of leukemia. But the leukemia cells have a high degree of heterogeneity and polymorphism, The diagnosis has certain limitations, greater subjectivity, clinical compliance rate, with karyotype analysis, will greatly improve diagnostic accuracy. Particularly on bone marrow cell morphology and cell staining in patients with atypical were particularly important. |
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