CAJ | 학술논문

目的应用实时定量聚合酶链反应(RQ-PCR)技术动态监测接受伊马替尼(IM)治疗的慢性粒细胞白血病(CML)患者bcr-abl融合基因拷贝数的变化,探讨RQ-PCR技术在微小残留病(MRD)检测以及预测复发方面的应用.方法应用RQ-PCR技术动态监测106例接受IM治疗的CML患者bcr-abl融合基因拷贝数,bcr-abl融合基因定量结果以校正比值(NQ)表示,NQ=bcr-abl拷贝数/abl拷贝数.结果 IM治疗前患者的NQ值与其疾病进展及Ph+细胞数量均显著相关(r=0.9824,r=0.9346).使用IM治疗的106例患者,62例在治疗12个月内NQ值迅速下降并长时间维持在较低水平,其中仅2例复发;8例在治疗后NQ值略有下降但随后又马上升高,其中7例在NQ值升高后的5~9个月内复发;31例治疗后NQ值未见明显下降且仍>0.1,其中11例获得过短暂的形态学缓解,随后迅速复发,7例治疗无效或疾病进展;另有5例虽然NQ值波动较大,且无规律性,但治疗后一直处于形态学缓解.结论 RQ-PCR方法准确、可靠、敏感度高,在监测CML患者的MRD、判断疗效以及预测复发等方面具有重要的临床应用价值.
목적 응용실시정량취합매련반응(RQ-PCR)기술동태감측접수이마체니(IM)치료적만성립세포백혈병(CML)환자bcr-abl융합기인고패수적변화,탐토RQ-PCR기술재미소잔류병(MRD)검측이급예측복발방면적응용.방법 응용RQ-PCR기술동태감측106례접수IM치료적CML환자bcr-abl융합기인고패수,bcr-abl융합기인정량결과이교정비치(NQ)표시,NQ=bcr-abl고패수/abl고패수.결과 IM치료전환자적NQ치여기질병진전급Ph+세포수량균현저상관(r=0.9824,r=0.9346).사용IM치료적106례환자,62례재치료12개월내NQ치신속하강병장시간유지재교저수평,기중부2례복발;8례재치료후NQ치략유하강단수후우마상승고,기중7례재NQ치승고후적5~9개월내복발;31례치료후NQ치미견명현하강차잉>0.1,기중11례획득과단잠적형태학완해,수후신속복발,7례치료무효혹질병진전;령유5례수연NQ치파동교대,차무규률성,단치료후일직처우형태학완해.결론 RQ-PCR방법준학、가고、민감도고,재감측CML환자적MRD、판단료효이급예측복발등방면구유중요적림상응용개치.
Objective To monitor the expression patterns of bcr-abl in chronic myeloid leukemia (CML) patients during treatment with imatinib mesylate and evaluate the detection of MRD by RQ-PCR method. Methods The ABI Prism 7500 Sequence Detection System using Taqman fluorogenic probes was used to quantify target gene. bcr-abl mRNA was detected by RQ-PCR in 106 CML patients. The normalized quotient (NQ) of bcr-abl mRNA was calculated as followings: NQ=bcr-abl mRNA copy numbers/abl mRNA copy numbers. Results The NQ of BCR-ABL mRNA was well correlated with the progression of disease and the number of Ph+ cell (r =0.9824 and 0.9346, respectively). The NQ was decreased rapidly in 62 patients and kept in low level for a long time, and only 2 of them were relapsed. For 8 patients, after treatment the NQwere decreased initially and increased sharply, 7 of them were relapsed after 5-9 months. After treatment the NQ of 31 patients were still>0.1, 11 patients were relapsed after a short remission and 7 were ineffective or progression. Out of 5 patients whose NQ were fluctuated and had little regularity, but all of them had a continuing remission. Conclusion RQ-PCR is a more sensitive technique in the detection of bcr-abl fusion gene.It is an important method to monitor the tumor cell during the treatment with imatinib mesylate in CML patients.