免疫分子诊断急性髓系白血病患者PML/RARα融合基因重排的诊断效能评价  

Evaluation of the efficacy of immunomolecular diagnosis of PML/RARα fusion gene rearrangement in patients with acute myeloid leukemia

作　　者：邹惠安 李琳芸 唐元艳[1] 陈永玲 梅冰[1] ZOU Huian;LI Linyun;TANG Yuanyan;CHEN Yongling;MEI Bing(Sec?ond Clinical Medical College of Yangtze University,Jingzhou 434020,China)

机构地区：[1]长江大学第二临床医学院,湖北 荆州 434020

出　　处：《实用医学杂志》2019年第21期3374-3377,3383,共5页The Journal of Practical Medicine

基　　金：湖北省卫生健康委科研项目(编号：WJ2019F125)

摘　　要：目的探讨急性髓系白血病免疫分子与PML/RARα融合基因之间的关系及免疫分子对PML/RARα融合基因表达的诊断效能。方法选取荆州市中心医院2016年7月至2019年2月初诊FAB分型为急性髓系白血病的患者120例,荧光定量PCR检测融合基因PML/RARα,流式细胞术检测CD分子表达,根据融合基因PML/RARα是否表达对患者进行分组,分析免疫分型CD分子表达差异及与融合基因PML/RARα表达的关联。结果PML/RARα阳性患者组CD64阳性患者率高达75.0%,CD34、HLA?DR、CD7阳性患者率分别为7.7%、7.7%、0;PML/RARα阴性患者组CD64阳性患者率为28.6%,CD7、CD34、HLA?DR阳性患者率分别为44.4%、77.8%、63.0%,差异均有统计学意义(P<0.05)。PML/RARα阳性患者中CD64阳性细胞率四分位数均高于PML/RARα阴性患者,CD7、CD34、HLA?DR阳性细胞率四分位数均低于PML/RARα阴性患者。两组间CD64、CD34、HLA?DR阳性细胞率差异均具有统计学意义(P<0.05)。CD34、HLA?DR、CD64诊断临界值分别为10.7%、11.1%、14.2%时诊断PML/RARα为阳性的敏感度和特异度较好。结论CD34、HLA?DR和CD64对诊断急性髓系白血病患者PML/RARα融合基因重排有较好的诊断性能。Objective To investigate the relationship between immune molecules and PML/RARαfusion gene and the diagnostic efficacy of immune molecules in PML/RARαfusion gene expression in patients with acute myeloid leukemia.Methods A total of 120 patients with acute myeloid leukemia(initially diagnosed with FAB)from July 2016 to February 2019 in Jingzhou Central Hospital were selected.The fusion gene PML/RARαwas de?tected by fluorescence quantitative PCR,and the molecular expression of CDs were measured by flow cytometry.The patients were divided into two groups according to PML/RARαexpression.The expression differences of CDs and their association with PML/RARαwere analyzed.Results In PML/RARαpositive group,patient with posi?tive CD64 expression accounted for 75.0%,and those with positive CD34,HLA?DR and CD77.7%,7.7%and 0,respectively.In PML/RARαnegative group,the rate of patients with positive CD64,CD7,CD34,and HLA?DR was 28.6%,44.4%,77.8%,and 63.0%,respectively.Differences of the rates of patient with positive CDs were statistically significant(P<0.05).Among PML/RARαpositive patients,the quartile of CD64 positive cells was higher than that of PML/RARαnegative patients,and the quartile of CD7,CD34 and HLA?DR positive cells were lower than that of PML/RARαnegative patients.There were statistically significant differences in the rates of CD64,CD34 and HLA?DR positive cells between the two groups(P<0.05).The sensitivity and specificity of posi?tive PML/RARαwas better when the diagnostic thresholds of CD34,HLA?DR and CD64 were 10.7%,11.1%and 14.2%,respectively.Conclusion CD34,HLA?DR and CD64 have good performance in the diagnosis of PML/RARαfusion gene rearrangement in patients with acute myeloid leukemia.

关 键 词：急性髓系白血病 PML/RARΑ 融合基因 免疫分子 

分 类 号：R73[医药卫生—肿瘤]