嗜酸性粒细胞增多症的细胞遗传学研究

为探讨染色体异常克隆在嗜酸性粒细胞增多症诊断和鉴别诊断中的意义及克隆性嗜酸性粒细胞增多症涉及的染色体异常,收集了65例嗜酸性粒细胞增多患者的骨髓标本,培养24小时,采用G显带进行核型分析。结果表明：65例中9例拟诊为急性髓细胞性白血病-M4Eo检出特异性的染色体异常inv（16）,而其余的56例以嗜酸性粒细胞增多待诊的患者中5例检出染色体异常克隆,检出率为8.9%。根据临床、血液学资料并结合染色体检出结果,5例患者最后分别被诊断为急性髓系白血病伴嗜酸性粒细胞增多、慢性嗜酸性粒细胞白血病、8p11骨髓增殖综合征、慢性髓系白血病急变、急性髓系白血病-M4Eo。检出的染色体异常克隆分别为＋14、t（5;12）（q31;p13）、t（8;9）（p11;q32）、t（9;22）（q34;q11）和inv（16）（p13q22）。结论：在嗜酸性粒细胞增多症的诊断中,染色体的检测是判定克隆性和诊断慢性嗜酸性粒细胞白血病的重要手段,应作为常规的检测。

Cytogenetic Study on Eosinophilia

The aim of study was to investigate the importance of chromosome aberration in differential diagnosis of eosinophilia and the chromosomal aberrations involved in patients with clonal eosinophilia.65 cases of eosinophilia were collected and chromosome specimens of bone marrow cells were prepared by 24-hour culture,and G-banding technique was used for karyotyping.The results showed that out of 65 cases,chromosome 16 inversion was detected in 9 patients suspected as M4Eo,and among the other 56 cases,5 were detected with chromosomal aberrations(8.9%).Combining clinical,hematological and cytogenetical data,the 5 patients were diagnosed as acute myeloid leukemia with eosinophilia,chronic eosinophilic leukemia,8p11 myeloproliferative syndrome,chronic myeloid leukemia in acute phase and acute myeloid leukemia-M4Eo respectively.The detected chromosomal aberrations were +14,t(5;12)(q31;p13),t(8;9)(p11;q32),t(9;22)(q34;q11)and inv(16)(p13q22).In conclusion,cytogenetical detection is very important in differential diagnosis of clonal eosinophilic disorders and chronic eosinophilic leukemia,which is suggested to be done routinely in clinic.