Bone marrow biopsies of patients with hematopoietic and lymphoid disorders - epidemiology, chromosomal aberrations and molecular pathology

Bone marrow biopsy of the iliac crest is the first and most important step in the diagnostics of hematopoietic disorders. The biopsies of the years 2006 and 2007 from the Institute of Pathology of the Jena University Hospital were retrospectively analyzed for clinicopathological parameters. In addition, the Mitelman database was retrieved for chromosomal aberrations. The analysis of 2820 reports from 1185 patients revealed that lymphomas, plasma cell myeloma and acute leukemia were most frequent. Males predominated in myeloproliferative neoplasms and lymphoma subtypes, particularly CLL, except for plasma cell myeloma and acute leukemia. A peak incidence was seen between 61 and 70 years of age with a varying pattern for single entities. The database search revealed that ALL, AML, CLL and CML were mainly diploid while Hodgkin lymphoma, mature B-cell lymphoma and multiple myeloma mostly carried hyperdiploid chromosome numbers. Numerical aberrations like chromosome 8 gains in hyperdiploid CML were prominent in specific subgroups. Molecular testing is exemplified in CML, plasma cell myeloma and hairy cell leukemia. The study highlights typical clinicopathological characteristics and new genetic findings in hematopoietic and lymphoid neoplasms with relevance for the new WHO classification and beyond. We hope that it may help in the differential diagnosis of bone marrow biopsies.     

Incidence of major chromosomal abnormalities in a referred population for suspected chromosomal aberrations: a report of 357 cases

The present report describes the cytogenetic findings in 357 cases referred for suspected chromosomal abnormalities because of abnormal clinical features. Chromosomal anomalies were found in 97 (27.2 %) of the cases studied. A significantly high rate of chromosomal abnormalities was found in a population with clinical abnormalities in comparison to an unselected population (0.48–0.55 %).     

新疆地区3512例新生儿染色体异常发生率的分析

本文采用Ｇ显带技术分析了３５１２例新生儿染色体。发现染色体异常有８例，其异常发生率为０．２３％。并根据历史事件，对本地区新生儿染色体异常发生率低于国内外的原因进行了分析。     

Role of p53 codon 72 polymorphism in chromosomal aberrations and mitotic index in patients with chronic hepatitis B

Polymorphisms of the p53 gene, which participates in DNA repair, can affect the functioning of the p53 protein. The Arg and Pro variants in p53 codon 72 were shown to have different regulation properties of p53-dependent DNA repair target genes that can affect various levels of cytogenetic aberrations in chronic hepatitis B patients. The present study aimed to examine the frequency of chromosomal aberrations and the mitotic index in patients with chronic hepatitis B and their possible association with p53 gene exon 4 codon 72 Arg72Pro (Ex4+119 G>C; rs1042522) polymorphism. Fifty-eight patients with chronic hepatitis B and 30 healthy individuals were genotyped in terms of the p53 gene codon 72 Arg72Pro polymorphism by PCR-RFLP. A 72-h cell culture was performed on the same individuals and evaluated in terms of chromosomal aberrations and mitotic index. A high frequency of chromosomal aberrations and low mitotic index were detected in the patient group compared to the control group. A higher frequency of chromosomal aberrations was detected in both the patient and the control groups with a homozygous proline genotype (13 patients, 3 control subjects) compared to patients and controls with other genotypes [Arg/Pro (38 patients, 20 control subjects) and Arg/Arg (7 patients, 7 control subjects)]. We observed an increased frequency of cytogenetic aberrations in patients with chronic hepatitis B. In addition, a higher frequency of cytogenetic aberrations was observed in p53 variants having the homozygous proline genotype compared to variants having other genotypes both in patients and healthy individuals.     

无创产前检测对于胎儿染色体拷贝数变异的检测价值

目的:探讨无创产前检测(non-invasive prenatal testing,NIPT)对于胎儿染色体拷贝数变异(copy number variations, CNVs)的检测价值。方法:收集18 661例接受NIPT检测的孕妇的临床资料,为提示胎儿携带CNVs的孕妇提供羊水染色体核型或/及染色体微阵列分析,并...     

Mate pair sequencing for the detection of chromosomal aberrations in patients with intellectual disability and congenital malformations

Recently, microarrays have replaced karyotyping as a first tier test in patients with idiopathic intellectual disability and/or multiple congenital abnormalities (ID/MCA) in many laboratories. Although in about 14–18% of such patients, DNA copy-number variants (CNVs) with clinical significance can be detected, microarrays have the disadvantage of missing balanced rearrangements, as well as providing no information about the genomic architecture of structural variants (SVs) like duplications and complex rearrangements. Such information could possibly lead to a better interpretation of the clinical significance of the SV. In this study, the clinical use of mate pair next-generation sequencing was evaluated for the detection and further characterization of structural variants within the genomes of 50 ID/MCA patients. Thirty of these patients carried a chromosomal aberration that was previously detected by array CGH or karyotyping and suspected to be pathogenic. In the remaining 20 patients no causal SVs were found and only benign aberrations were detected by conventional techniques. Combined cluster and coverage analysis of the mate pair data allowed precise breakpoint detection and further refinement of previously identified balanced and (complex) unbalanced aberrations, pinpointing the causal gene for some patients. We conclude that mate pair sequencing is a powerful technology that can provide rapid and unequivocal characterization of unbalanced and balanced SVs in patient genomes and can be essential for the clinical interpretation of some SVs.     

妇科临床遗传咨询患者染色体异常频率和构成的研究

通过总数近９０００例的胎儿丢失夫妇、出生缺陷儿夫妇、原发不孕夫妇及原发闭经和继发闭经患者血染色体检查结果的分析，考查了上述几类妇科常见人群的染色体异常频率和构成，探讨了它们在遗传组成上可能的联系和区别。     

少、弱精子及无精子症患者染色体核型分析

目的探讨染色体异常对少弱精子及无精子症的影响.方法对199例男性少、弱精子及无精子症患者进行外周血淋巴细胞培养,G显带染色体核型分析.结果染色体核型异常20例, 占10.1%; 染色体变异19例,占5.3%.结论染色体异常是导致少、弱精子及无精子症的重要因素之一.     

三代测序技术在染色体变异检测中的应用初探

目的:应用纳米孔三代测序技术检测人类染色体非整倍体样本,并探讨其性能及应用前景。方法:使用MinION三代测序仪对从分别携带X染色体单体和7q11.23-q21.3区22.5 Mb缺失的两种人类细胞系样本中提取的DNA进行检测,并对测序结果进行数据统计和序列分析。结果:两例样本在24小时内分别获得了555 872和2 ...     

酪氨酸激酶抑制剂治疗后慢性髓细胞白血病患者Ph阴性细胞中染色体异常的遗传学特征和转归

目的 观察酪氨酸激酶抑制剂治疗后慢性髓细胞白血病(chronic myelogenous leukemia,CML)Ph阴性细胞中染色体异常(chromosomal abnormalities in Ph negative cells,Ph- CAs)的遗传学特征和转归.方法 对15例接受酪氨酸激酶抑制剂治疗后出现Ph- CAs的CML患者进行遗传学和分子学动态观察.结果 出现Ph- CAs患者中,依马替尼治疗12例,达沙替尼治疗2例,伯舒替尼治疗1例,染色体异常以+8最为多见,占46.7％.Ph- CAs出现在ph+克隆减少或消失时,出现的平均时间为11.1个月(1～28个月);7例Ph- CAs已经消失,Ph- CAs持续的平均时间为10.9个月(3～24个月).Ph- CAs出现时,所有病例均未见骨髓病态造血或急性白血病;Ph- CAs出现后,除1例患者演变为ph+急性单核细胞白血病外,其余均获得骨髓缓解,11例获完全细胞遗传学反应,4例获完全分子学反应.结论 依马替尼、达沙替尼和伯舒替尼治疗CML患者均可能出现Ph- CAs;Ph- CAs多数为一过性,对酪氨酸激酶抑制剂治疗效果无影响.     

Current molecular and emerging nanobiotechnology approaches for the detection of microbial pathogens

Waterborne microbial diseases are escalating worldwide increasing the need for powerful and sensitive diagnostics tools. Molecular methodologies, including immunological and nucleic acid-based methods, have only recently been applied in the water sector. Advances in nanotechnology and nanomaterials have opened the door for the development of new diagnostic tools with increased sensitivity and speed, and reduced cost and labor. Quantum dots, flo dots, gold nanoparticles, magnetic nanoparticles, carbon nanotubes, nanowires, and nanocantilevers, with their unique optical and physical properties, have already been applied in nanodiagnostics. Nanobiotechnology, once remaining technical and practical problems has been addressed, will play an important role in the detection of microbial pathogens.     

Application of molecular techniques in the diagnosis, prognosis and management of patients with colorectal cancer: a practical approach

There has been an increasing role for molecular diagnostics in the diagnosis and management of cancer, and colorectal carcinoma is no exception. Recent molecular advances have elucidated 3 broad molecular subtypes of colorectal cancer, including chromosomal instability, microsatellite instability, and cytosine-phosphoguanine island methylator phenotype, which will be discussed. Also, the common syndromes associated with colorectal carcinoma will be reviewed with a focus on the differentiation between Lynch syndrome and microsatellite unstable tumors. Molecular biomarkers for predictive and prognostic markers are also becoming widely used, and due to the clinical use of monoclonal antibodies to the epidermal growth factor receptor, an emphasis is placed on that pathway.     

Spontaneous chromosomal aberrations in patients with precancerous and cancerous lesions of the cervix uteri

Chromosomal aberrations were studied in metaphases from peripheral blood cultures of 52 women with cancer of the cervix uteri, 89 cases of various grades of cervical precancerous lesions, and 47 age-matched normal (control) women. The frequency of metaphases with chromosome and chromatid aberrations was 17.24% in cancer patients, 10.41% in those with precancerous lesions, and 6.39% in control women. There was a significant (p less than 0.001) increase in the frequency of chromosome aberrations in patients with cervical precancerous and cancerous lesions, compared with controls. After the exclusion of the treated cases, cancer patients also revealed a highly significant (p less than 0.001) increase in the frequency of chromosome aberrations, compared with controls. The results of the present study indicate the existence of chromosomal instability in the majority of cervical cancer patients and in some cases of precancerous lesions. The increased frequency of spontaneous chromosome aberrations in patients with precancerous lesions may be of importance for the understanding of their biological behavior.     

Meningeal relapse in a patient with acute promyelocytic leukemia: a case report and review of the literature

The involvement of central nervous system is rare in acute promyelocytic leukemia (APL). We report a APL patient of a 41 yr-old Korean male who presented with fever and petechia. Complete molecular remission was achieved with all-trans retinoic acid (ATRA), idarubicin, and cytarabine. Ten months later, he complained of a mild headache. The results of the physical examination and the complete blood counts were normal. The examination of cerebrospinal fluid showed the presence of promyelocyte. Bone marrow studies showed cytogenetic remission but with molecular relapse. He was treated with intrathecal and systemic chemotherapy.     

实时定量PCR检测白血病中BCL11B基因的表达水平

目的建立BCL11B基因的定量检测方法,并分析其在白血病中的表达水平。方法利用实时定量RTPCR分析TALL(12例)、BALL(8例)、BCLL(6例)、AML(7例)和正常对照(10例)外周血单个核细胞(PBMC)中BCL11B基因的表达水平,以β2微球蛋白(β2M)基因表达水平作为内对照。结果TALL患者PBMC中BCL11B表达水平(553.84±564.01拷贝105β2M拷贝)明显高于正常对照和其他白血病患者(P=0.006,P=0.013,P=0.031,P=0.020);而AML组BCL11B表达水平(0.02±0.04拷贝105β2M拷贝)则明显低于正常对照组(P=0.000)、BALL组(P=0.006)和TALL组(P=0.020);BALL(1.99±1.59拷贝105β2M拷贝)和BCLL(2.26±3.57拷贝105β2M拷贝)中BCL11B表达水平与正常对照(2.20±1.01拷贝105β2M拷贝)无显著差别。结论建立了实时定量RTPCR检测BCL11B方法,TALL中BCL11B高表达可能与其发病有一定关系。     

浙江省首次发现新型布尼亚病毒感染病例及分离病毒分子鉴定

目的 了解浙江省是否存在新型布尼亚病毒潜在自然疫源地,分离疑似病例血清中新型布尼亚病毒并进行鉴定.方法 免疫荧光法检测浙江省台州地区野生啮齿动物不同组织标本中新型布尼亚病毒抗原.实时荧光定量RT-PCR检测疑似病人血清中新型布尼亚病毒核酸,扩增产物进行序列测定.Vero细胞分离疑似病人血清中新型布尼亚病毒,以新型布尼亚病毒株核衣壳蛋白编码基因为靶基因,采用RT-PCR及扩增产物测序对分离的疑似新型布尼亚病毒株进行鉴定,另对该序列进行同源性分析和比较.结果 70只野生啮齿动物中,免疫荧光法检测阳性率为5.71%.实时荧光定量RT-PCR检测结果显示,4例疑似病人血清中有两例检测结果阳性.1例阳性血清样本中分离出1株疑似新型布尼亚病毒,RT-PCR和测序结果证实该病毒确为新型布尼亚病毒,其核衣壳蛋白编码基因序列与湖北省新型布尼亚病毒分离株相似性高达92.2%,但与国内其他地区新型布尼亚病毒分离株序列差异较大.结论 首次证实浙江省存在新型布尼亚病毒自然疫源地及感染病人,不同群新型布尼亚病毒分布可能存在一定的地理差异.     

Numerical chromosomal changes and risk of development of myelodysplastic syndrome--acute myeloid leukemia in patients with Fanconi anemia

Fanconi Anemia (FA) is an inherited bone marrow failure syndrome characterized by congenital abnormalities, progressive marrow failure and predisposition to myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), and solid tumors. The most common acquired chromosomal aberrations in FA patients are trisomy of 1q and monosomy of chromosome 7; the latter is known to be associated with poor prognosis. A few reports also suggest that gains of 3q are associated with progression to MDS–AML and overall poor prognosis. It is not uncommon for patients with Fanconi anemia to have easily detectable (oligoclonal) chromosomal alterations in their still normal (nonmalignant) marrow, which makes it even more challenging to determine the import of such alterations. We conducted a retrospective longitudinal analysis of fluorescent in situ hybridization (FISH) analysis for gains in 1q and 3q and for monosomy 7 and 7q deletions on 212 bone marrow samples from 77 children with FA treated at our institution between 1987 and 2007. Given the baseline increased chromosomal instability and defective DNA repair in patients with FA, which leads to unbalanced chromosomal aberrations such as deletions, insertions, and translocations, for the purpose of this analysis an abnormal clone was defined as ≥10% abnormal cells. Chromosome 3 and 7 aberrations were associated with increased risk of developing MDS–AML (P = 0.019 and P < 0.001 respectively), although the significance of chromosome 3 aberrations disappeared when different observation times were accounted for. Gain of 1q alone did not predict development of MDS–AML. In conclusion, children with FA should be followed closely with FISH analyses, because some of the clonal chromosomal abnormalities may be early indicators of progression toward MDS–AML and thus also of the need for hematopoietic stem cell transplantation.