应用RT-PCR和荧光原位杂交监测急性早幼粒细胞白血病微小残留白血病  

Detection of minimal residual disease in patient with acute promyelocytic leukemias by RT-PCR and FISH

作　　者：张济[1,2] 李羿[3] 李君君[1] 颜家运[1] 刘静[2] 

机构地区：[1]南华大学附属第一医院血液科,湖南衡阳421001 [2]中南大学湘雅医学院分子生物学研究中心,湖南长沙410078 [3]空军雷达学院宜昌校区卫生队,湖北宜昌443111

出　　处：《中国实验诊断学》2012年第3期423-425,共3页Chinese Journal of Laboratory Diagnosis

基　　金：湖南省教育厅科研项目基金资助(编号:10C1161)

摘　　要：目的应用RT-PCR和荧光原位杂交技术(FISH)检测急性早幼粒细胞白血病(APL)患者体内PML-RARα融合基因的表达,监测患者体内微小残留白血病的情况。方法采用全反式维甲酸(ATRA)和三氧化二砷(As2O3)联合治疗APL,运用RT-PCR和FISH技术检测和分析APL患者体内诱导缓解后及巩固维持治疗后PML-RARα融合基因。结果 46例APL患者PML-RARα融合基因均为阳性,其中34例患者在诱导化疗结束达完全缓解后检测,25例(73.5%)患者基因检测呈阴性,9例(26.5%)患者RT-PCR和/或FISH检测阳性,融合基因阳性和阴性复发APL的预测值分别为44.4%和4.3%;31例再经ATRA及As2O3巩固及维持治疗后,27例患者达到分子生物学缓解,无复发病例,4例融合基因阳性患者,3例复发APL,其复发APL的阳性预测值为75%。结论 RT-PCR和FISH技术是非常有效的监测APL患者体内微小残留白血病的实验方法,其对疾病的诊断、治疗及预后评估具有重要临床价值。Objective To monitor minimal residual disease（MRD） in patients with acute promyelocytic leukemia（APL） by detecting PML-RARα fusion gene throung reverse transcriptase polymerase chain reaction（RT-PCR） and fluorescence in situ hybridization（FISH）.Methods Patients suffered from APL were treated by combining ATRA with As2O3,PML-RARαfusion gene from the patients was detected by RT-PCR and FISH at the end of induction therapy,consolidation and maintenance therapy course.Results PML-RARα fusion gene from 46 patients with APL was positive.At the end of induction therapy,9 samples Out of 34 showed the presence of PML-RARα,25 samples did not detect fusion gene by RT-PCR and/or FISH.The predictive value of relapse in the patients who had positive and negative fusion gene were 44.4% and 4.3%,respectively.At the end of consolidation and maintenance therapy,27 samples Out of the 31 who showed no presence of PML-RARα have been in remission,3 samples from 4 patients who were positive relapsed,The predictive value of relapse was 75% during this period.Conclusion RT-PCR and FISH play an important and efficient role to diagnose APL,monitor MRD,modify treatment program and evaluate the prognosis of APL.

关 键 词：APL RT-PCR FISH 微小残留白血病 

分 类 号：R733.7[医药卫生—肿瘤]