儿童与成人急性B淋巴细胞白血病临床及分子遗传学比较  

Clinical and molecular genetic characteristics between childhood and adult acute B lymphocytic leukemia

作　　者：侯玮玮[1] 刘永春[1] 朱玲玲[1] 

机构地区：[1]苏北人民医院儿科,江苏扬州225001

出　　处：《交通医学》2017年第1期17-19,共3页Medical Journal of Communications

摘　　要：目的:比较儿童与成人B淋巴细胞白血病(B lymphocytic leukemia,B-ALL)临床特征及分子遗传学的差异。方法:收集185例儿童以及98例成人B-ALL患者临床资料及骨髓或血液标本,应用多重巢式反转录PCR、定量RT-PCR等技术检测融合基因ETV6-RUNX1、TCF3-PBX1以及BCR-ABL,CRLF2基因表达。结果:儿童组WBC<30×109/L比例高于成人组,差异有统计学意义(P<0.0001)。儿童组中CRLF2过表达32例(17.3%),成人组中CRLF2过表达14例(14.28%),两者差异无统计学意义(P>0.05)。儿童组中发生t(12;21)/ETV6-RUNX1融合基因27例(14.59%),成人组仅1例,两者差异有统计学意义(P<0.0001)。儿童组出现t(9;22)/BCR-ABL融合基因17例(9.19%),成人组29例(29.59%),两者差异有统计学意义(P<0.0001)。t(1;19)/TCF3-PBX1融合基因在儿童组中检测到7例,成人组中未检测到,两者差异有统计学意义(P<0.0001)。结论:儿童B-ALL与成人B-ALL在临床及分子遗传学特征方面有显著差异,分子遗传学检测可能为个体化治疗提供依据,并有助于寻找新的治疗靶点。Objective：To compare the difference of clinical characteristics and molecular genetics between childhood and adult acute B lymphocytic leukemia（B-ALL）.Method：The clinical data and bone marrow or peripheral blood samples in 185 cases of childhood and 98 cases of adult B-ALL were collected.Multiple nested reverse transcription PCR,quantitative RT-PCR techniques were applied to detect fusion genes ETV6 RUNX1,TCF3 PBX1,BCR-ABL and CRLF2 overexpression.Results：Children with WBC30×109/L ratio were higher than adult patients,the difference was statistically significant（P〈0.0001）.CRLF over expression was detected in 32 children cases（17.30%） and 14 adult cases（14.28%）,there was no statistically significant difference between them（P〈0.05）.t（12;21）/ETV6-RUNX1 fusion genes were statistically significant difference between the children and adults,with 27cases（14.59%） in children and only 1 case in adults（P〈0.0001）.Children patients with t（9;22）/BCR-ABL fusion genes were 17 cases（9.19%）,and adult patients with 29 cases（29.59%）,the difference was statistically significant（P〈0.0001）.t（1;19）/TCF3-PBX1 fusion gene were detected in 7 children,while they were not detected in adults（P〈0.0001）.Conclusion：Childhood and adult B-ALL has significant difference in clinical characteristics and molecular genetics.It may provide the basis for individualized treatment,and help to find new therapeutic targets.

关 键 词：急性B淋巴细胞白血病 儿童 成人 分子遗传学 

分 类 号：R733.71[医药卫生—肿瘤]