特发性血小板减少性紫癜和骨髓增生异常综合征NRAS与FMS基因突变的研究

目的 探讨特发性血小板减少性紫癜(ITP)的发病机制并探讨其与骨髓增生异常综合征(MDS)的鉴别诊断.方法 用聚合酶链反应一单链构象多态性(PCR-SSCP)方法检测MDS患者突变频率较高的NRAS基因12、13密码子及FMS基因301、969密码子点突变在中老年ITP患者及MDS患者中的出现频率.结果 25例ITP患者中有1例存在NRAS基因突变,1例存在FMS基因301密码子突变;8例MDS患者中有3例出现基因突变,其中2例为NRAS基因突变,1例为FMS基因突变.结论 PCR-SSCP方法检测NRAS基因12、13密码子,FMS基因301、969密码子突变有可能用于鉴别诊断ITP与MDS,ITP患者中出现NRAS基因、FMS基因突变者应归入MDS.

N-ras and fms gene mutation in idiopathic thrombocytopenic purpura and myelodysplasia

OBJECTIVE: To explore the pathogenesis of idiopathic thrombocytopenic purpura (ITP) and improve the differential diagnosis from myelodysplastic syndromes (MDS). METHODS: Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was performed to detect the point mutation of codon 12,13 in N-ras gene and codon 301, 969 in fms gene in adult and aged ITP and MDS patients. RESULTS: In 25 ITP patients, N-ras mutation and fms mutation were detected in one each (4%). Mutations were found in 3 of 8 MDS patients: two (25%) with N-ras mutation and one (12.5%) with fms mutation. CONCLUSIONS: Patients with N-ras or fms gene mutation diagnosed as MDS rather than ITP.