M与m-bcr/abl融合基因转录子共表达与CML患者血小板增多的关系  

Study on the co-expression of M and m-bcr/abl fusion gene transcripts on thrombocytosis in patients with chronic myelogenous leukemia

作　　者：孟文彤[1] 粟军[2] 曾诚[2] 刘霆[1] 李建军[1] 史青[2] 余江[2] 崔旭[1] 

机构地区：[1]四川大学华西医院血液科血液病学研究室,四川成都610041 [2]四川大学华西医院实验医学科,四川成都610041

出　　处：《检验医学》2007年第6期667-671,共5页Laboratory Medicine

摘　　要：目的研究共表达m-bcr/abl融合基因转录子对初诊慢性髓系白血病(CML)患者的巨核细胞形态的影响。方法分别用逆转录-聚合酶链反应(RT-PCR)和巢式PCR检测M和m-bcr/abl融合基因转录子。盲法计数患者骨髓涂片1.0 cm×1.5 cm2面积内巨核细胞数,随机选取20个巨核细胞分类计数并测定成熟期巨核细胞直径;计数产板型巨核细胞产血小板数。结果107例初诊CML患者M和m-bcr/abl共表达者56例,b3a2型31例,b2a2型25例。共表达m-bcr/abl的b3a2型初诊CML患者血小板数比单表达M-bcr/abl和b2a2型m-bcr/abl(+)患者高(P<0.05)。对巨核细胞形态观察,在b3a2和b2a2组,共表达m-bcr/abl和单表达M-bcr/abl的患者骨髓1.0 cm×1.5 cm面积内巨核细胞数、成熟巨核细胞数和直径差异均无统计学意义(P>0.05);共表达m-bcr/abl的b3a2型患者产板型巨核细胞产板数比单表达M-bcr/abl患者高(P<0.05);而b2a2型的共表达m-bcr/abl组和单表达M-bcr/abl组1.0 cm×1.5 cm面积内巨核细胞数、成熟巨核细胞数和直径及产板型巨核细胞产板数差异均无统计学意义(P>0.05)。结论共表达m-bcr/abl的b3a2型初诊CML患者血小板数增高是由其巨核细胞产板数多造成的,而与其巨核细胞数、产板型巨核细胞数和直径无关。Objective To study the effect of co-expression of M and m-bcr/abl fusion gene transcripts on megakaryocytes in patients with chronic myelogenous leukemia（CML）. Methods M and m-bcr/abl fusion gene transcripts were detected by reverse transcription polymerase chain reaction （RT-PCR） and nested PCR respectively. Using blind trial, megakaryocytes were counted in 1.0 cm ×1.5 cm on smear; 20 megakaryocytes random selected were differentiately counted and their diameter were detected; and platelets from thrombocytogenic megakaryocytes were counted. Results There were 56 patients （31 patients with b3a2 and 25 patients with b2a2） co-expressing M and m-bcr/abl in 107 patients with CML. In CML patients with the b3a2 at diagnosis co-expressing m-bcr/abl, platelet counts in periph- eral blood were more than ones with M-bcr/abl alone and the b2a2 co-expressing m-bcr/abl （P 〈 0.05 ）. As to megakaryocytes, between the b3a2 and the b2a2, there were no difference in megakaryocytes in 1.0 cm ×1.5 cm, kinds of megakaryocytes, cell diameters of the patients co-expressing m-bcr/abl and one＇ s with m-bcr/abl alone （ P 〉 0.05 ）. Platelets from thrombocytogenic megakaryocytes in patients with the b3a2 co-expressed m-bcr/abl were more than ones with M-bcr/abl alone （P 〈0.05 ）. In patients with b2a2, two groups had no difference in megakaryocytes in 1.0 cm×1.5 cm, kinds of megakaryocytes, cell diameters and platelet from thromocytogenic megakaryocytes （ P 〉 0.05 ）. Condusious b3a2 CML patients co-expressing m-bcr/abl have a tendency to cause augmentation of platelet count, because their megakaryocytes produce more platelets; and there is no relation between megakaryocyte counts, kinds of megakaryocyte and cell diameter.

关 键 词：基因 慢性髓细胞白血病 M-bcr/abl m-bcr/abl 共表达 巨核细胞 

分 类 号：Q753[生物学—分子生物学]