多发性骨髓瘤血浆循环游离DNA定量检测和完整性分析  

Quantitative Detection and Integrality Analysis of Plasma Circulating Cell-Free DNA in Multiple Myeloma

作　　者：张岚鑫 蒋艺枝 邱丽君 黄东平 ZHANG Lan-Xin;JIANG Yi-Zhi;QIU Li-Jun;HUANG Dong-Ping(Department of Hematology,The First Affiliated Hospital of Wannan Medical College,Wuhu 241000,Anhui Province,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院血液科,安徽芜湖241000

出　　处：《中国实验血液学杂志》2024年第4期1106-1111,共6页Journal of Experimental Hematology

摘　　要：目的:研究血浆循环游离DNA(cf-DNA)在初诊多发性骨髓瘤(MM)患者筛查诊断中的作用,并探讨经化疗后患者的cf-DNA含量和完整性的变化在疾病评估中的作用。方法:收集35例初诊MM患者和18例健康志愿者的外周血标本,另选取MM患者中完成规范诱导化疗3个疗程的13例患者作为随访组。以ALU247片段及ALU115片段为目的基因,用荧光定量PCR检测患者及健康志愿者血浆中的cf-DNA含量,并以ALU247/ALU115比值计算cf-DNA的完整性。结果:MM患者ALU247、ALU115片段浓度和cf-DNA完整性均显著高于健康志愿者(均P<0.05)。经3个疗程诱导化疗的患者治疗后的ALU247和ALU115片段浓度以及cf-DNA的完整性均较治疗前显著降低(均P<0.05),且治疗前后cf-DNA完整性与血清M蛋白含量及骨髓异常浆细胞比例之间均存在较强正相关关系(r_(M蛋白)=0.703,r_(骨髓浆细胞)=0.705)。结论:cf-DNA对于MM的筛查诊断具有一定的积极意义。cf-DNA或许可以协同或者替代血清M蛋白含量及骨髓异常浆细胞比例评估患者的病情、疗效及预后。Objective:To investigate the role of plasma circulating cell-free DNA(cf-DNA)in the screening and diagnosis of patients with newly diagnosed multiple myeloma(MM)and explore the changes of cf-DNA in terms of content and integrality in the assessment of disease in patients treated with chemotherapy.Methods:Peripheral blood specimens were collected from 35 newly diagnosed MM patients and 18 healthy volunteers,and 13 of the 35 patients who had finished 3 courses of standard induction chemotherapy were selected as follow-up group.The ALU247 and ALU115 fragments were used as the target genes,and the cf-DNA content in the plasma of patients and healthy controls was measured by quantitative polymerase chain reaction(qPCR).The integrality of cf-DNA was calculated by the ratio of ALU247 to ALU115.Results:Both the concentration of ALU247 and ALU115 fragments and the integrality of cf-DNA in patients were significantly higher than those in healthy controls(all P<0.05).Patients who had underwent 3 courses of induction chemotherapy had significantly decreased concentration of ALU247 and ALU115 fragments and integrality of cf-DNA after treatment(all P<0.05),and strong positive correlations were manifested between cf-DNA integrality and serum M protein content,as well as proportion of abnormal plasma cells in bone marrow before and after treatment(r=0.703,0.705).Conclusions:Cf-DNA has certain positive significance for the screening and diagnosis of MM.Furthermore,cf-DNA may be a synergism or alternative to serum M-protein content and proportion of abnormal plasma cells in bone marrow in assessing the condition,curative effect and prognosis of patients.

关 键 词：初诊多发性骨髓瘤 循环游离DNA ALU247 ALU115 完整性 

分 类 号：R733.3[医药卫生—肿瘤]