间期荧光原位杂交检测血液病染色体三体8

目的 探讨间期荧光原位杂交(FISH)技术在检测血液病染色体三体8中的价值.方法 用荧光素直接标记的8号染色体着丝粒探针对77例血液病患者进行间期FISH检测,并与常规细胞遗传学方法(CC)进行比较分析.结果 FISH法三体8的检出率较传统吉姆萨显带高,或在吉姆萨显带无法分析时提供结果.结论 FISH检测三体8的敏感性高于常规核型分析,在小克隆检测方面有其优越性.     

荧光原位杂交技术检测BCR/ABL融合基因阳性的病例分析

目的:本研究应用快速、高敏感性和特异性的荧光原位杂交技术(fluorecence in situ hybridization,FISH)检测BCR/ABL融合基因并对阳性病例进行分析.方法:回顾性分析2010年4月至2012年4月用FISH法检测初诊考虑为慢性骨髓增殖性疾病(chronic myeloproliferative disease,CMPD)或骨髓增生异常/骨髓增殖性疾病(myelodysplastic myeloproliferative disorders,MDS/MPD)、急性淋巴细胞白血病患者(acute lymphocyte leukemia,ALL)及口服格列卫的慢性髓系白血病(chronic myeloid leukemia,CML)和ALL患者的BCR/ABL 融合基因的表达情况.结果:BCR/ABL融合基因阳性的病例共456例,其中经骨髓细胞学初诊为CML的350例,占总阳性病例的76.8％;CML复查病例为85例,占总阳性病例的18.6％;诊断为B细胞型ALL(B-ALL)的21例,占总阳性病例的4.6％.31例初诊为CMPD和MDS/MPD的患者中,有5例患者骨髓形态学诊断为CML,应用FISH法检测BCR/ABL融合基因均为阳性(100％);另26例患者骨髓形态学诊断为非CML的CMPD及MDS/MPD,BCR/ABL融合基因均为阴性(100％).79例骨髓形态学诊断为ALL患者应用FISH法检测BCR/ABL融合基因,其中阳性病例为21例,占ALL病例的26.6％.45例初次口服格列卫的CML患者,6个月达到主要分子生物学缓解(major molecular response,MMR)或完全分子生物学缓解(complete molecular response,CMR)的为21例,占46.7％,12个月为40例,占88.9％.2例CML移植患者分别在91天和16个月发现融合基因阳性.结论:FISH法检测BCR/ABL融合基因快速、简单、特异性高、可靠,弥补了染色体检测报告需要时间长等不足.对CMPD和MDS/MPD的诊断及鉴别诊断有重要价值;可明确Ph+ ALL患者的诊断;在监测格列卫疗效和微小残留病灶(minimal residual desease,MRD)方面也有重要意义.     

三体22在预测inv(16)急性髓细胞白血病中的重要意义

目的：探讨三体22在诊断inv(16)急性髓细胞白血病(AML)中的意义。方法：分别采用Spectrum Green标记的22号染色体着丝粒DNA探针(CEP22)1和以红、绿荧光素直接标记的MYHll基因断裂点分开的两侧序列作为探针。对1例伴inv(16)／ 22克隆异常的AML及1例单纯 22克隆异常的AML进行单色间期FISH和D—FISH检测．并与细胞形态学及常规细胞遗传学(CC)相比较。结果：2例经采用CEP22探针的FISH技术证明确实存在三体22克隆性异常，而D-FISH均证实inv(16)阳性。其中1例的少数间期核(1．6％)同时伴有16p13的微小缺失。结论：由于 22是一种染色体数目异常，相对来说易于辨认，可以看做是预报inv(16)AML的重要信号，具有潜在的诊断inv(16)AML的价值。     

荧光原位杂交和免疫组织化学方法检测乳腺癌组织中人类表皮生长因子受体2基因状态差异及其特征分析

目的比较荧光原位杂交(fluorescence in situ hybridization,FISH)和免疫组织化学(immunohistochemistry,IHC)检测乳腺癌组织中人类表皮生长因子受体2(human epidermal growth factor receptor 2,HER-2)基因状态差异,分析其相关特征。方法回顾性收集51例中山大学附属第三医院2007年10月至2008年9月间乳腺浸润性导管癌组织标本和相关信息,分别采用IHC和FISH法检测HER-2蛋白表达情况和基因扩增状态,比较两种方法的结果差异,用Fisher精确概率检验分析这种差异的相关因素。结果在51例标本中,FISH检测乳腺癌组织中HER-2基因阴性32例(62.75%,32/51),阳性19例(37.25%,19/51);IHC检测乳腺癌组织中HER-2为(-)和(+)者的FISH检测均为阴性(21例);12例IHC检测HER-2为(++),其中3例FISH检测为阳性,其余9例FISH检测为阴性;18例IHC检测HER-2为(+++)者仍有2例FISH检测结果阴性。月经状态和雌激素受体(ER)表达与IHC检测HER-2阳性病例的FISH阳性结果具有显著联系(P值分别为0.023和0.007),即在IHC检测HER-2阳性[(++)和(+++)]的病例中,绝经前女性较绝经期女性以及ER阴性者较阳性者更可能为FISHHER-2阳性(有HER-2基因扩增)。结论本研究的结果有助于提高IHC判断HER-2基因扩增的准确性。     

应用荧光原位杂交法检测乳腺癌石腊样本中HER-2 基因的扩增

 目的 探讨荧光原位杂交法（Fluorescence in situ hybridization，FISH）检测乳腺癌HER-2基因扩增在临床病理诊断及分子靶向治疗中应用的可能性。方法 用FISH技术和免疫组化（Immunohisto—chemistry，IHC）技术检测50例乳腺导管癌石蜡包埋标本并比较两种方法的结果以及与临床病理的关系。结果 16／50例HER-2蛋白表达阳性，其中强阳性5例，中度阳性9例，弱阳性2例；11／50（22％）例乳腺癌标本FISH技术检测HER-2基因扩增阳性，其中5／5为免疫组化HER-2蛋白强阳性病例；6／9为中度阳性病例，其中1例为17号染色体多倍体与HER-2基因扩增。HER-2基因扩增与蛋白表达与乳腺癌转移有关（P〈0．05）。结论 FISH技术可稳定地检测用IHC确定的HER-2蛋白阳性乳腺癌中HER-2基因的扩增状况，并用于临床赫赛汀分子靶向治疗病例的筛选。     

细胞遗传学和间期FISH在淋巴瘤诊断中的应用

目的评估细胞遗传学和荧光原位杂交技术(FISH)对临床和(或)细针穿刺细胞学检查诊断为淋巴瘤或不能除外淋巴瘤病例的价值。方法同时采用常规组织学、免疫组织化学、细胞遗传学检查和间期FISH技术方法,对223例直径≥1.5cm淋巴结的手术活检标本进行系统性研究。FISH探针采用直接荧光标记的IGH LSI~(?)双色分开探针。结果2例患者的取材因坏死成分较多无法诊断。221例患者的病理诊断中,霍奇金淋巴瘤(HL)44例(19.9%),非霍奇金淋巴瘤(NHL)162例(73.3%),其他恶性病变4例(1.8%),良性病变11例(5.0%)。间期FISH结果显示,HL的免疫球蛋白重链基因(IGH)异常的发生率为13.6%(6/44),NHL为51.2%(83/162),良性病变为0% (0/11),差异有统计学意义(P<0.001)。细胞遗传学和间期FISH联合检查时,HL和NHL的检出率分别提高到15.9%和77.8%,其中有3例为组织病理学和免疫组化检查不能定性者。结论间期FISH是检测IGH基因异常的快速和敏感的手段。细胞遗传学和间期FISH检测是淋巴瘤诊断的重要辅助手段。     

双色双融合荧光原位杂交检测bcr/abl融合基因的临床意义

目的 检测bcr/abl融合基因在慢性粒细胞白血病（CML）,急性淋巴细胞白血病（ALL）和真性红细胞增多症（PV）中的表达,以了解其临床意义。方法 采用双标记双融合bcr/abl探针进行荧光原位杂交（D-FISH）。检测了7例患者骨髓中期和（或）间期细胞。结果 38例CML患者中bcl/abl阳性为34例,占89.5%,其中1例患者发病时,细胞遗传学显示典型的t(9;22),应用干扰素治疗38个月后,bcr/abl基因转为阴性;1例异基因外周血造血干细胞移植术后60d的患者,细胞形态学及细胞遗传学均显示完全缓解,但FISH检测仍有3.0%的细胞为bcr/abl基因因阳性,24例ALL患者中,6例bcr/abl阳性,占25.0%,2例PV患者bcr/abl阴性,3例CML待排的患者bcr/abl均阴性,其中1例确诊为原发性血小板增多症;1例进一步检测ETO/AML1基因后诊断为M2a;1例仍未能明显诊断,3例bcr/abl阴性的CML中,难治性白血病2例;6例bcr/abl阳性的ALL中,难治性白血病5例,结论 用双色双融合bcr/abl探针进行FISH杂交,可准确地检测出bcr/abl融合基因,是临床诊断,判定预后及微小残留病的有效监测指标。     

荧光原位杂交法检测乳腺癌HER-2表达与腋淋巴结转移相关性的研究

目的:探讨用荧光原位杂交法(FISH)检测乳腺癌HER-2基因的表达与腋淋巴结转移的相关性.方法:采用免疫组化方法检测乳腺癌组织中HER-2的表达,再用FISH进一步检测阳性病例中HER-2基因的扩增情况,比较两者结果的差异,并且分析HER-2的表达与腋淋巴结转移的相关性.结果:免疫组化(IHC)法检测HER-2阳性42例,FISH检测阳性9例,FISH法检测HER-2基因与HER-2蛋白过表达之间相关(P＜0.05),并且IHC和FISH两种方法检测HER-2表达均与腋淋巴结转移有相关性(P＜0.05).结论:FISH可稳定检测HER-2基因的扩增,其表达与腋淋巴结转移相关.     

儿童急性淋巴细胞白血病TEL-AML1融合基因检测

 目的　检测儿童急性淋巴细胞白血病（ALL）中TEL-AML1融合基因的阳性率,探讨TEL-AML1融合基因的检测方法及其临床应用价值。方法　在形态学、免疫分型、细胞遗传学基础上,采用巢式反转录-聚合酶链反应（RT-PCR）和荧光原位杂交技术（FISH）检测31例ALL患儿骨髓单核细胞中TEL-AML1融合基因。结果　巢式RT-PCR技术和FISH技术均可以显著提高TEL-AML1融合基因的检出率,应用上述两种方法,31例患儿中检测出7例TEL-AML1阳性,占儿童初发ALL的22.6 %（7／31）,在B系ALL中的阳性率为25.9 %（7／27）。结论　t(12;21)形成TEL-AML1融合基因是儿童ALL最常见的染色体易位,常规染色体核型分析极难发现,需用巢式RT-PCR或FISH等分子检测方法加以证实。     

非典型bcr-abl融合基因急性淋巴细胞白血病一例并文献复习

目的 探讨少见b3a3型bcr-abl融合基因急性淋巴细胞白血病(ALL)的诊断及其特点.方法 对2010年确诊为ALL的1例患者进行核型分析,并通过荧光原位杂交(FISH)技术检测bcr-abl融合基因的存在,采用反转录聚合酶链反应(RT-PCR)检测该融合基因的断裂位点.结果 该患者的核型表现为45,XY,-7,t(9;22) (q34;q11),FISH检测发现了bcr-abl融合基因的存在,RT-PCR检测出该融合基因的断裂位点为少见的b3a3型.结论 常规的检测方法只能检测出典型的bcr-abl融合基因,而非典型bcr-abl融合基因需结合多种检测手段才能检测出阳性结果.少见b3a3型bcr-abl融合基因及其融合蛋白的功能和潜在利用价值还有待发掘.     

Monosomy 20 as a pointer to dicentric (9;20) in acute lymphoblastic leukemia.

Twenty new cases of acute lymphoblastic leukemia (ALL) with the dicentric chromosome dic(9;20)(p1113;q11) are presented. This chromosomal abnormality is difficult to identify from G-banding alone. It masquerades as monosomy 20 and is only accurately identified by fluorescence in situ hybridization (FISH). Monosomy 20 was found in 59/2790 patients with successful karyotypes entered to the Leukaemia Research Fund/UK Cancer Cytogenetics Group Karyotype Database in ALL (LRF/UKCCG Karyotype Database). FISH revealed dic(9;20) in 20/25 cases with available material. Extra copies of chromosome 21 were found in 8 of the 20 cases. Patients were 14 females and six males, aged 1-32 years (median 4 years), with leukocyte counts of 2-536 (median 23) x 109/l and immunophenotypes of common or pre-B ALL (17 cases), T-ALL (one case) or unknown (two cases). Four patients relapsed at 2, 22, 28 and 47 months and two died at 49 and 63 months (median follow-up 37 months). FISH studies on the remaining five patients showed one with monosomy 20 and four with other rearrangements of the chromosome. This study has increased the number of reported cases of dic(9;20) from 17 to 37. It has identified dic(9;20) in one case of T-ALL and shows an association of this translocation with trisomy 21.     

Detection of translocations affecting the BCL6 locus in B cell non-Hodgkin's lymphoma by interphase fluorescence in situ hybridization.

Structural alterations in 3q27 affecting the BCL6 locus are among the most frequent changes in B-NHL. The aim of the present study was to establish an interphase-FISH assay for the detection of all diverse BCL6 translocations in B-NHL. Two different approaches were tested, one using a PAC-clone spanning the major breakpoint region (MBR) of BCL6 (span-assay), and another using two BAC clones flanking the MBR (flank-assay). Interphase FISH with the span-assay detected the various BCL6 translocations in seven B-NHL cell lines. The dual-color flank-assay was evaluated in two laboratories independently: in normal controls, the cutoff level for false-positive signals was 2.6%, whereas the cutoff level for false-negatives in the seven cell lines was 7.5%. To test the feasibility of the FISH strategies, 30 samples from patients with B-NHL with cytogenetic abnormalities of 3q27 were evaluated with both assays. In 21 cases, the span-assay indicated a BCL6 rearrangement. In 18 of the 21 cases, the dual-color flank-assay confirmed the translocation including 12 different partner chromosomal loci. The three false-positive cases detected with the span-assay showed trisomy of chromosome 3 by cytogenetic analyses, and they were correctly classified as non-rearranged with the flank-assay. In summary, our FISH strategy using two differently labeled flanking BCL6 BAC probes provides a robust, sensitive, and reproducible method for the detection of common and uncommon abnormalities of BCL6 gene in interphase nuclei. The routine application of this assay to patients with B-NHL will allow the assessment of the diagnostic and prognostic significance of BCL6 rearrangements.     

急性粒-单核细胞白血病的细胞遗传学异常研究

背景与目的：2001年WHO分型特别提出4种伴再现性遗传学异常的急性髓细胞白血病（AML），其中inv（16）（p13：q22）与急性粒一单核细胞白血病（M4）密切相关，是预后好的标志。本研究旨在探讨M4的细胞遗传学特征。方法：采用直接法及短期培养法制备骨髓细胞染色体，并以R显带技术对89例M4患者进行核型分析，并应用间期荧光原位杂交（I-FISH）技术对其中伴有＋22异常的患者进行inv（16）检测。结果．89例M4患者中，异常染色体检出率为40．4％（36／89），共12种主要异常核型，其中5种为特异性染色体异常，见于25例患者，占核型异常患者的69．4％。单纯＋8（10例）为最常见的数目异常；结构异常最多见的是inv（16）（5例）；t（8；21）者3例；伴t（9；22）者有1例；其中5例inv（16）及3例＋22均只见于M4Eo患者。3例＋22患者FISH检测inv（16）均阳性。结论：细胞遗传学研究对于急性粒一单核细胞白血病的诊断具有重要价值，但是细胞遗传学对inv（16）检测阳性低，对怀疑病例及所有＋22异常的患者，应尽可能进行FISH检测。     

荧光原位杂交技术检测慢性B-CLL第12号染色体三体畸变

目的 检测２０例慢性Ｂ淋巴细胞白血病（Ｂ－ＣＬＬ）中第１２号染色体三体畸变。方法 运用荧光原位杂交技术（ＦＩＳＨ）。结果 ６例（３０％）患者有１２号染色体三体（＋１２）,其中５例经染色体核型分析发现的＋１２均得到证实。在１例Ｂ－ＣＬＬ中,染色体分析未发现任何分裂相,而ＦＩＳＨ检测发现了＋１２克隆。在另１例Ｂ－ＣＬＬ中,ＦＩＳＨ不仅证实了染色体核型检查发现的存在于扁桃体的＋１２,同时还发现了染色体分     

Clinical significance of hTERC and C-Myc genes amplification in a group of Egyptian patients with cancer cervix

Background: Cervical cancer is the second most common cancer in women worldwide after breast cancer. Cervical cancer is a preventable disease. The implementation of cervical cancer screening programs has greatly decreased the morbidity and mortality, as precancerous lesions and early invasive cervical cancer could be detected and treated effectively. The detection of hTERC gene amplification was suggested as a possible diagnostic marker for use in routine cytological screening. Objectives: The present study was designed to detect genomic gains of the hTERC and C-MYC genes using FISH technique and to investigate the relationship between genes amplification and the clinical data of the patients. Patients and Methods: The current study was carried out on twelve cases with cervical cancer at different grades (three cases were grade I, six cases were grade II and three cases were grade III). Interphase FISH analysis using LSI probe, Cervical Cancer probe hTERC (3q26) & C-MYC (8q24), was successfully performed on 12 patients with cancer cervix. Results: Interphase FISH analysis revealed positive hTERC gene amplification in all cases of cancer cervix (100%). However C-MYC gene amplification was detected in four cases only (33.3%). Statistical analysis of the data revealed significant correlation between hTERC amplification and grading. Also, there was significant correlation between C-MYC amplification and grading and highly significant correlation between C-MYC amplification and hTERC amplification. On the other hand hTERC and C-MYC genes amplification showed an inverse correlation with the ages of the patients. Conclusion: The present study highlights the importance of using hTERC and C-MYC genes FISH probes for cases with cancer cervix or pre-malignant lesions as a sensitive technique. This method provides an easy and effective applicable approach which helps in the diagnosis and prognosis, as an increased copy number is associated with a more advanced grade that could be detected in the early stages of the disease. Keywords: Cancer cervix, Telomerase, hTERC amplification.     

慢性淋巴细胞白血病的分子遗传学特点

目的 了解慢性淋巴细胞白血病（CLL）的分子遗传学特性。方法运用间期荧光原位杂交（FISH）技术对60例初发的B细胞CLL（B-CLL）患者进行12号染色体3体（＋12）、del（13q14）和del（17p13）检测。结果60例患者中,41例（68．3％）至少有一种分子遗传学异常,2例（3．3％）具有2种染色体异常。12例（20．0％）有＋12异常,其畸变细胞率在4．0％-34．0％之间;24例（40．0％）有del（13q14）异常,其畸变细胞率在22．0％～93．0％之间,其中3例有2条染色体del（13q14）异常;7例（11．7％）有del（17p13）异常,其畸变细胞率在6．0％～68．0％之间。不同Binet分期中,3种分子遗传学异常差异无统计学意义。结论FISH是一种在分析CLL染色体数目和结构异常方面较为快速、准确和敏感的方法,可为CLL的研究提供较为准确的分子遗传学信息。     

AML1 gene over-expression in childhood acute lymphoblastic leukemia.

The present study was conducted on a series of 41 Egyptian children with newly diagnosed acute lymphoblastic leukemia (ALL) to investigate TEL and AML1 abnormalities. The TEL-AML1 fusion was observed in six patients both by RT-PCR and FISH analyses, with a frequency of 22.2% among the B-lineage group, whereas TEL deletion was seen by FISH analysis in seven patients (17.1%). By FISH analysis, nine patients (22%) showed evidence of extra AML1 copies. In five of these patients the extra copies were due to non-constitutional trisomy 21, whereas in the remaining four cases they were due to tandem AML1 copies on der(21), as evidenced by metaphase FISH. Unexpectedly however, enhanced AML1 expression levels were seen by real-time quantitative RT-PCR in 18 out of the 41 ALL patients (43.9%). This high level of AML1 expression could be an important factor contributing to the pathogenesis and progression of childhood ALL. One key mechanism for over-expression seems to be the extra copies of AML1, but other mechanisms may involve an alteration of the activity of the AML1 promoter. Here, we also report two novel findings. The first is an intragenic deletion of TEL exon 7 in a case of T cell ALL. This deletion creates a frame-shift and results in a truncated protein lacking the C-terminus that includes the ETS domain. This shorter TEL is presumably unable to bind DNA. The second finding is a rearrangement of AML1 in a case of T cell ALL due to t(4;21)(q31;q22). This is the first reported chromosomal translocation where AML1is rearranged in childhood T cell ALL.     

Comparison of a quantitative PCR method with FISH for the assessment of the four aneuploidies commonly evaluated in CLL patients.

Four chromosomal defects associated with outcome are commonly evaluated by fluorescent in situ hybridization (FISH) in chronic lymphocytic leukemia (CLL), namely deletions of the 13q13-q14, 11q22 and 17p13 regions and trisomy 12. In this study, we compared a quantitative PCR method--quantitative multiplex PCR of short fluorescent fragment (QMPSF)--with FISH for the detection of these acquired aneuploidies in a series of 110 patients with Binet stage A CLL. Genes located in the deleted or gained regions were selected as target genes and amplified using a method based on the simultaneous amplification of short fluorescent genomic fragments under quantitative conditions. A chromosomal imbalance involving one or several of the four loci was detected by either method in 72 patients (65%). A chromosome 13 deletion was present in 61 patients (54%), a 11q22 deletion in nine (8%), a trisomy 12 in nine and a 17p deletion in one. FISH and QMPSF results were identical for 103 out of 110 patients and discrepancies could be explained in most cases. This study demonstrates that a quantitative multiplex PCR represents a cost-effective method that could replace FISH in CLL patients. However, although QMPSF is perfectly adapted to the detection of primary defects, care should be taken when searching for clonal evolutions present in a small proportion of tumor cells.     

Interphase fluorescence in situ hybridization analysis detects a much higher rate of thyroid tumors with clonal cytogenetic deviations of the main cytogenetic subgroups than conventional cytogenetics

In benign thyroid lesions, three main cytogenetic subgroups, characterized by trisomy 7 or structural aberrations involving either chromosomal region 19q13.4 or 2p21, can be distinguished by conventional cytogenetics (CC). As a rule, these aberrations seem to be mutually exclusive. Interphase fluorescence in situ hybridization (I-FISH) analysis on benign as well as malignant thyroid neoplasias has been performed in the past, but rarely in combination with CC. In the present paper, we have analyzed 161 benign thyroid lesions both with CC and I-FISH on touch preparations by using a multi-target, triple-color FISH assay as well as dual-color break-apart probes for detection of the main cytogenetic subgroups. Within the samples, I-FISH detected tumors belonging to either of the subgroups more frequently than CC (23 vs. 11.4%), either due to small subpopulations of aberrant cells or to cryptic chromosomal rearrangements (three cases). Thus, I-FISH seems to be more sensitive than CC, particularly in the detection of subpopulations of cells harboring cytogenetic aberrations that may be overlooked by CC. In summary, I-FISH on touch preparations of benign thyroid lesions seems to be a favorable method for cytogenetic subtyping of thyroid lesions.