老年人急性白血病T细胞受体VγI-Jγ基因重排分析  

Analysis of T cell receptor VγI-Jγgene rearrangement in elderly patients with acute leukemia

作　　者：徐兵[1] 魏永强[1] 赵永忠[1] 周淑芸[1] 孟凡义[1] 

机构地区：[1]第一军医大学南方医院血液科,广东广州510515

出　　处：《第一军医大学学报》2003年第12期1266-1269,共4页Journal of First Military Medical University

基　　金：广东省重点科技攻关项目(99M04911G)~~

摘　　要：目的为研究老年人急性白血病分子生物学特点及临床意义。方法提取34例老年人急性非淋巴细胞白血病(ANLL)、9例老年人急性淋巴细胞白血病(ALL)及10名正常献血员DNA标本,应用PCR技术扩增TCRVγI-Jγ基因重排,对阳性的PCR产物进行SSCP分析。结果34例老年人ANLL中有16例(47.1%)发现TCRVγI-Jγ基因重排,老年人ANLL TCRVγI-Jγ基因重排检测阳性率显著高于非老年人ANLL组(P<0.025)。9例老年人ALL中有7例(77.8%)发现TCRVγI-Jγ基因重排,其中3例(33.3%)存在寡/亚克隆重排,老年人ALL寡/亚克隆重排阳性率显著高于非老年人ALL组(P<0.05)。10例正常献血员PCR技术扩增TCRVγI-Jγ基因重排均为阴性。TCRVγI-Jγ基因重排阳性老年人ANLL完全缓解率为25.0%(4/16),显著低于重排阴性老年人ANLL组(61.1%)(P<0.05)。结论应用PCR/SSCP方法分析老年人急性白血病TCRγ重排可作为疗效和预后判断的新指标。老年人急性白血病寡/亚克隆重排检测阳性率显著高于非老年人组可能是导致其疗效差的一个重要因素。Objective To obtain insight into the molecular mechanism of acute leukemia in elderly patients in relation to theclinical features of the disease. Methods DNA specimens were obtained from 34 elderly patients with acute nonlymphoblasticleukemia (ANLL), 9 elderly patients with acute lymphoblastic leukemia (ALL) and 10 healthy blood donors. Polymerase chainreaction (PCR) coupled with single-strand conformation polymorphism (SSCP) was performed to detect T cell receptor (TCR)VγI-Jγgene rearrangement. Results In the 34 elderly ANLL patients, 47.1% (16/34) were found with TCRVγI-Jγgenerearrangement, showing a higher rate of therearrangement than in younger ANLL patients (P<0.025). TCRVγI-Jγgenerearrangement was identified in 7 (77.8%) of the 9 elderly patients with ALL, and 3 of the identified cases had oligoclonal/subclonal rearrangement, suggesting a higher rate of oligoclonal/subclonal rearrangement in elderly ALL patients than inyounger ALL patients (P<0.01). None of the blood donors was found with TCRVγI-Jγgene rearrangement. The completeremission rate was lower in the elderly ANLL patient with TCRVγI-Jγgenerearrangement than in those without (P<0.05).Conclusion The detection of TCRVγI-Jγgenerearrangement can be of value in assessing the therapeutic effect and makingprognostic prediction in elderly patients with acute leukemia.

关 键 词：老年人 急性白血病 T细胞受体 VγI-Jγ 基因重排 

分 类 号：R733.7[医药卫生—肿瘤]