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53例骨髓增殖性肿瘤的临床分析

Clinical Analysis of 53 Patients With Myeloproliferative Neoplasms

摘要目的 加强对骨髓增殖性肿瘤(MPN)的认识,提高其诊疗水平.方法 选择2007年3月至2012年2月江苏省兴化市人民医院收治的53例MPN患者为研究对象.回顾性分析其临床资料和相关实验室检查结果.结果 ①MPN发病高峰年龄为40~79岁,占86.79%(46/53);以慢性粒细胞白血病(CML)最为多见,占66.04%(35/53);临床表现不典型,脾大占77.36%.②MPN中不同疾病外周血血红蛋白(HB),RBC,WBC及PLT差异有统计学意义(P<0.05).③6例真性红细胞增多症(PV)和4例原发性血小板增多症(ET)患者进行了JAK2V617F突变基因检查,阳性率分别为83.33%和75%;9例CML-慢性期患者检测了BCR/ABL基因,阳性率为100%.结论 MPN有发病年轻化的趋势,脾大为常见体征,血细胞持续增多结合JAK2V617F突变基因和BCR/ABL基因检测,可以准确诊断MPN,避免漏诊误诊.

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abstractsObjective To enhance the awareness of myeloproliferative neoplasms(MPN)and improve the diagnosis and treatment of the diseases.Methods From May 2007 to February 2012,a total of 53 cases of MPN patients who were treated by Xinghua People's Hospital were included in this study. A retrospective analysis of these patients' clinical data and laboratory test results were carried out.Results ① The peak age of MPN onset was 40 to 79 years old,accounting for 86.79% (46/53). Chronic myeloid leukemia(CML) was the most common of these patients,accounting for 66.04% (35/53).Splenomegaly was a typical clinical manifestations for MPN patients and there were 41 splenomegaly patients in all of the cases,accounting for77.36%. () There were significant differences in peripheral blood cells among the MPN patients(P<0.05).JAK2V617F gene mutation was detected in 6 cases of polycythemia vera (PV) and 4 cases of essential thrombocythemia (ET) patients were detected the JAK2V617F mutation,with the positive rates of 83.33% and 75%,respectively.BCR/ABL mutation was detected in all of 9 CML-chronic phase patients.Conclusions Incidence of MPN was the trend of younger.Enlarged spleen was a common sign.It would be an effective means to make accurate diagnosis and avoid misdiagnosis of MPN for combining the continue increasing blood cells and gene mutation of JAK2V617F and BCR/ABL.

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