实时荧光定量PCR检测急性淋巴细胞白血病患者TCR VγI-Jγ基因重排  

Establishment of a real time quantitative-PCR assay for detection of TCR VγI-Jγ gene rearrangement in acute lymphoblastic leukemia patients

作　　者：江小工[1] 徐兵[1] 许文娟[1] 李冰[1] 

机构地区：[1]第一军医大学南方医院血液科,广州510515

出　　处：《中华血液学杂志》2004年第7期425-428,共4页Chinese Journal of Hematology

基　　金：广东省科技计划项目 (2 0 0 2C3 0 3 0 4)

摘　　要：目的　探索提高急性淋巴细胞白血病 (ALL)微量残留病 (MRD)检测技术。方法　构建实时荧光定量聚合酶链反应 (PCR)检测TCRVγI Jγ基因重排技术并定量分析 36例ALL患者的检测结果。结果　建立的实时荧光定量PCR方法的灵敏度为 10 -4水平。 36例患者荧光定量PCR方法检测结果初治组为 (7.38± 6 .6 5 )× 10 -2 ,完全缓解 (CR)组为 (1.0 2± 1.0 8)× 10 -2 ,造血干细胞移植(HSCT)组为 (3.89± 5 .6 5 )× 10 -3 。CR组和HSCT组TCRVγI Jγ基因重排水平显著低于初治组 (P值均为 0 .0 0 1) ,HSCT组MRD水平显著低于CR组 (P <0 .0 5 )。 6例HSCT后检测阳性病例中 2例MRD水平 <1× 10 -3 ,获长期无病生存 ,另 4例MRD水平较高患者一年内均出现复发。结论　所建立的实时荧光定量PCR方法简便、快速、灵敏及特异 ;Objective To improve the techniques for minimal residual disease(MRD) detection in acute lymphoblastic leukemia (ALL). Methods A real time quantitative PCR method was established for quantifying the clonal TCRVγI Jγ gene rearrangement in 36 ALL patients. Results The sensitivity of the established real time quantitative PCR was at 10 -4 level. The amount of TCRVγI Jγ gene rearrangement in newly diagnosed group, complete remission(CR) group and post hematopoietic stem cell transplantation(HSCT) group was (7.38±6.65)×10 -2 , (1.02±1.08)×10 -2 and (3.89±5.65)×10 -3 level,respectively. and the amount in newly diagnosed group was higher than that in CR group and HSCT group(P=0.001). The MRD level of ALL patients in CR group was higher than that in HSCT group(P=0.022).MRD can be detected in 6 ALL patients after HSCT, 2 of them with low MRD level(<1×10 -3 )survived long disease free survival, the other 4 with high MRD level relapsed within one year. Conclusion The established real time quantitative PCR assay is simple, rapid,sensitive and specific . Use of this assay to evaluate MRD in the remission ALL cases is helpful for prognosis prediction.

关 键 词：荧光定量PCR检测 急性淋巴细胞白血病 ALL TCR VrI—Jr基因 基因重排 多聚酶链反应 

分 类 号：R733.7[医药卫生—肿瘤]