依据免疫球蛋白基因重排构建的实时定量聚合酶链反应体系在B淋巴细胞白血病微小残留病监测中的应用  

Application of immunoglobulin gene rearrangement-derived real-time quantitative polymerase chain reaction in monitoring minimal residual disease of B-cell lymphoblastic leukemia

作　　者：蔡大利[1] 高琳琳[2] 毕奇[2] 苏楠[1] 代娣[2] 程仕彤[2] 李艳[1] 郭晓临[2] Cai Dali Gao Linlin Bi Qi Su Nan Dai Di Cheng Shitong Li Yan Guo Xiaolin(Department of Hematalogy, the First Hospital of China Medical University, Shenyang 110001, China Department of Clinical Chemistry, the First Hospital of China Medical University, Sheayang 110001, China)

机构地区：[1]中国医科大学附属第一医院血液科,沈阳110001 [2]中国医科大学附属第一医院检验科,沈阳110001

出　　处：《白血病．淋巴瘤》2017年第7期390-395,共6页Journal of Leukemia & Lymphoma

基　　金：沈阳市科学技术计划（F13-221-9-70）

摘　　要：目的 依据B淋巴细胞白血病存在的特异免疫球蛋白（Ig）轻、重链基因重排构建白血病细胞的特异定量检测方法,并将其用于B淋巴细胞白血病微小残留病的监测.方法 利用欧洲BIOMED-2体系和方法分析15例B淋巴细胞白血病患者的Ig轻、重链基因的重排序列,并据此为患者分别设计白血病细胞特异性引物,建立个体化实时定量聚合酶链反应（qPCR）体系,用于监测患者治疗后白血病微小残留病.结果 15例患者中,14例检测出个体及白血病细胞特异的Ig轻、重链基因重排序列,其中10例患者构建的Ig-qPCR反应体系具有高度特异性,检测敏感度达到10-5水平,符合国际标准,满足临床需要.该方法与其他临床常用检测白血病微小残留病的方法结果相似.结论 依据Ig基因重排设计的白血病负荷检测方法对大多数B淋巴细胞白血病患者敏感、特异、准确,能为治疗的选择提供可靠依据.Objective To establish a real-time quantitative polymerase chain reaction （qPCR） assay for B-cell lymphoblastic leukemia according to individualized and specific immunoglobulin gene rearrangements in leukemia cells, and to use it for the monitoring of minimal residual disease （MRD） of B-cell lymphocytic leukemia. Methods The immunoglobulin gene rearrangements of bone marrow samples from 15 cases of B-cell lymphoblastic leukemia were analyzed with a validated European BIOMED-2 system, and the individualized and specific qPCR-based quantification of leukemic immunoglobulin gene rearrangements was established. Results Unique and specific gene rearrangements of immunoglobulin light and heavy chains were identified in 14 cases and Ig-qPCR based on these gene rearrangements had a sensitivity of 10-5 and high specificity which met the international criteria in 10 patients. Leukemia MRD quantification with immunoglobulin gene rearrangement-based qPCR was similar as compared with other MRD detection methods. Conclusion Immunoglobulin gene rearrangement-based leukemia MRD quantification is feasible, sensitive, specific, precise and much valuable for clinical decision of treatments in B-cell lymphoblastic leukemia.

关 键 词：白血病 B细胞 肿瘤 残余 免疫球蛋白基因重排 聚合酶链反应 

分 类 号：R733.7[医药卫生—肿瘤]