基于UCLA DNA交换室间质评的HLA分型策略探讨  

Discussion on HLA typing strategy via UCLA DNA external quality assessment

作　　者：齐珺[1] 刘孟黎[1] 王小芳[1] 王天菊[1] 陈利萍[1] 王满妮[1] 叶世辉[1] 

机构地区：[1]陕西省血液中心,陕西西安710061

出　　处：《中国输血杂志》2015年第10期1197-1201,共5页Chinese Journal of Blood Transfusion

摘　　要：目的探讨提高HLA分型精准性的策略。方法采用聚合酶链反应-序列特异寡核苷酸探针技术、聚合酶链反应-测序分型方法和针对组特异性的序列特异性引物扩增和杂合性模棱两可引物分离法等方法对2009-2014年288份HLA质控品进行HLA低/中/高分辨分型并回报每期结果。结果 HLA分型精准性随着分型方法及试剂的改进更新不断提高,自2011年质控品高分辨提交比例升高至60.6%-94.1%;分型方法的限制性和等位基因指定性错误是导致质控中错检漏检的常见原因。288份质控品检出的等位基因中,仅HLA-A*26∶05、B*08∶12、B*53∶10不包含在美国组织相容性和免疫遗传协会常见及确认的等位基因表2.0内,且A、B、DRB1座位分别有8、22和14个等位基因不包含在中国CWD2.0表内。结论 HLA分型方法试剂的更新换代和实验室质控水平的提升是室间质评分辨度和符合率大幅提高的根本原因。样品因地域种族差异,常呈现出中国人少见或罕见的HLA表型或单体型,ASHI及中国CWD、单体型频率、罕见等位基因频率等群体性资料和生物信息学仍是极具参考价值的数据平台。Objectives To explore the optimal strategy for HLA typing accuracy. Methods The HLA low, middle or high resolution genotyping of 288 samples of DNA Exchange during 2009 -2014 were detected and submitted by polymerase chain reaction-sequence specific oligonucleotide （PCR-SSO）, polymerase chain reaction sequencing-based typing （PCR- SBT）, group specific-sequence specific primers （SSP） and heterozygous ambiguity resolving primers （HARPS）. Results HLA typing accuracy was improved with the advanced typing methods and reagents. The submitted proportion of HLA high resolution typing of DNA Exchange was increased to 60. 6% -94. 1% since 2011. The limitation of typing methods and des- ignated allele error were the two common causes of error or leak detection of HLA EQA. Among the detected alleles of 288 control samples, HLA-A ＊ 26： 05, B ＊ 08：12 and B ＊ 53：10 were not included in American Society for Histocompatibility and Immunogeneties （ASHI） Common Alleles and Well Documented Alleles （CWD） 2. 0 list. There were 8, 22 and 14 alleles at A, B and DRB1 locus respectively not within Chinese CWD2. 0 list. Conclusion Renewal and upgrading of HLA typing methods or reagent, as well as the elevated laboratory quality control level are the fundamental causes of the substantial im- provement of resolution and concordant rate in EQA activities. Uncommon or rare HLA phenotype or haplotype in Chinese of- ten emerged in samples due to geographical or ethnic differences, so HLA bioinfonnatics and population data including ASHI and Chinese CWD, haplotype frequencies, rare allelic frequencies are still data platform with great reference value.

关 键 词：HLA分型 室间质评 等位基因 单体型频率 

分 类 号：R446.11[医药卫生—诊断学] Q503[医药卫生—临床医学]