Application of fluorescencein situ hybridization technique to verify the clonalities of non-clonal cytogenetic abnormalities identified in Myelodysplastic syndrome
Application of fluorescencein situ hybridization technique to verify the clonalities of non-clonal cytogenetic abnormalities identified in Myelodysplastic syndrome
目的 探讨应用荧光原位杂交(FISH)技术验证骨髓增生异常综合征(MDS)经传统染色体显带分析(CBA)检测到的非克隆性染色体异常(n-CCA)的价值。 方法 回顾性分析2011年10月至2020年12月北京大学人民医院CBA检测具有n-CCA的91例MDS患者的临床资料及染色体核型和FISH检测结果。 结果 在91例患者中，CBA共检测到94例次非克隆性+8、5q-、-7、7q-和20q-异常，其中43例次(45.7%)经FISH验证为阳性，+8、5q-、-7、7q-和20q-的验证率分别为47.6%(30/63)、25%(2/8)、41.7%(5/12)、40%(2/5)和66.7%(4/6)，FISH阳性的细胞占比为4% ~ 90%(中位7%)。将91例患者按CBA分析的中期分裂相数目分为3组，即≥ 20、10 ~ <20、< 10。3组的FISH验证率分别为43.7%(31/71)、33.3%(3/9)、63.6%(7/11)，未见明显差异( P>0.05)。对26例仅接受支持治疗的患者进行连续监测，结果显示91.7%(11/12)经FISH验证的异常持续存在，而92.9%(13/14)FISH验证为阴性的n-CCA属于一过性异常。 结论 约半数CBA检测到的n-CCA经FISH证实为克隆性异常，FISH验证的阳性率与CBA的中期分裂相数目无关。对于CBA检测出的n-CCA，建议通过FISH检测验证其克隆性并进行连续追踪观察。 Objective To assess the value of fluorescence in situ hybridization (FISH) technique for the verification of the clonalities of non-clonal cytogenetic abnormalities (n-CCA) identified by conventional chromosome banding analysis (CBA) in patients with Myelodysplastic syndrome (MDS). Methods Clinical data and results of karyotyping and FISH assays for 91 patients of MDS with n-CCA identified by CBA were retrospectively analyzed. Results In total 94 non-clonal + 8, 5q-, -7, 7q- or 20q- were detected by CBA, among which 43 (45.7%) were verified to be clonal abnormalities by FISH. The detection rates for + 8, 5q-, -7, 7q- and 20q- by FISH were 47.6% (30/63), 25% (2/8), 41.7% (5/12), 40% (2/5) and 66.7% (4/6), respectively, with the positive cells accounting for 4% to 90% of all counted cells, with a median value of 7%. The 91 patients were divided into three groups including ≥ 20, 10 ~ <20 and < 10 based on the numbers of metaphase cells in CBA, and the detection rates by FISH for the three groups were 43.7% (31/71), 33.3% (3/9) and 63.6% (7/11), respectively, which showed no statistically difference ( P >0.05). Continuous CBA and FISH surveys were conducted for 26 patients who received supportive treatment, and the results revealed that 91.7% (11/12) of FISH-verified positive abnormalities had persisted, whereas 92.9% (13/14) of the n-CCA verified as negative by FISH was transient. Conclusion Nearly half of the CBA identified n-CCA have been verified as clonal aberrations by FISH, and the FISH detection rate showed no correlation with the number of metaphase cells. FISH test is strongly recommended for verifying the clonalities of n-CCA detected by CBA, and continuous cytogenetic survey of the patients with MDS is necessary.
Abstract
Objective To assess the value of fluorescence in situ hybridization (FISH) technique for the verification of the clonalities of non-clonal cytogenetic abnormalities (n-CCA) identified by conventional chromosome banding analysis (CBA) in patients with Myelodysplastic syndrome (MDS). Methods Clinical data and results of karyotyping and FISH assays for 91 patients of MDS with n-CCA identified by CBA were retrospectively analyzed. Results In total 94 non-clonal + 8, 5q-, -7, 7q- or 20q- were detected by CBA, among which 43 (45.7%) were verified to be clonal abnormalities by FISH. The detection rates for + 8, 5q-, -7, 7q- and 20q- by FISH were 47.6% (30/63), 25% (2/8), 41.7% (5/12), 40% (2/5) and 66.7% (4/6), respectively, with the positive cells accounting for 4% to 90% of all counted cells, with a median value of 7%. The 91 patients were divided into three groups including ≥ 20, 10 ~ <20 and < 10 based on the numbers of metaphase cells in CBA, and the detection rates by FISH for the three groups were 43.7% (31/71), 33.3% (3/9) and 63.6% (7/11), respectively, which showed no statistically difference ( P >0.05). Continuous CBA and FISH surveys were conducted for 26 patients who received supportive treatment, and the results revealed that 91.7% (11/12) of FISH-verified positive abnormalities had persisted, whereas 92.9% (13/14) of the n-CCA verified as negative by FISH was transient. Conclusion Nearly half of the CBA identified n-CCA have been verified as clonal aberrations by FISH, and the FISH detection rate showed no correlation with the number of metaphase cells. FISH test is strongly recommended for verifying the clonalities of n-CCA detected by CBA, and continuous cytogenetic survey of the patients with MDS is necessary.
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