CAJ | 학술논문

目的探讨急性髓系白血病(AML)染色体畸变所形成的融合基因与MICM分型及临床诊断、治疗、预后的关系.方法采用多重巢式RT-PCR方法对60例AML患者的融合基因联合染色体核型、免疫表型、临床资料进行研究.结果 60例AML中有37例(61.67%)具有5种融合基因:MLL-AF9、TLS-ERG、CBFβ-MYH1、AML1-ETO、PML-RARα.13例患者有HOX11原癌基因活化,10例为单纯表达HOX11原癌基因活化,3例同时伴有其他融合基因表达.伴AML1-ETO、PML-RARα的31例患者中接受化疗的23例全部达完全缓解(CR),且无复发.结论基因分型是AML最精确的分型方法 ,可为临床化疗提供指导.采用多重巢式RT-PCR方法可快速同时检测急性白血病29种染色体畸变所形成的融合基因,完善白血病的MICM分型,指导临床个体化治疗.
목적 탐토급성수계백혈병(AML)염색체기변소형성적융합기인여MICM분형급림상진단、치료、예후적관계.방법 채용다중소식RT-PCR방법 대60례AML환자적융합기인연합염색체핵형、면역표형、림상자료진행연구.결과 60례AML중유37례(61.67%)구유5충융합기인:MLL-AF9、TLS-ERG、CBFβ-MYH1、AML1-ETO、PML-RARα.13례환자유HOX11원암기인활화,10례위단순표체HOX11원암기인활화,3례동시반유기타융합기인표체.반AML1-ETO、PML-RARα적31례환자중접수화료적23례전부체완전완해(CR),차무복발.결론 기인분형시AML최정학적분형방법 ,가위림상화료제공지도.채용다중소식RT-PCR방법 가쾌속동시검측급성백혈병29충염색체기변소형성적융합기인,완선백혈병적MICM분형,지도림상개체화치료.
Objective To analyse the fusion genes derived from chromosome structural aberrations in acute myeloid leukemia(AML) and the relationship between fusion genes and the MICM classification, clinical diagnosis, chemotherapy and prognosis. Methods The expression of fusion gene in bone marrow samples was detected with multiplex RT-PCR technique and chromosome karyotypes, immunological phenotypes and clinical data were analyzed in 60 acute myeloid leukemia newly diagnosed. Results 37 cases(61.67 %) of 60 patients carried 5 kinds of fusion genes consisting of MLL-AF9, TLS-ERG, CBFβ-MYH1, AML1-ETO and PML-RARα. The activation of oncogene HOX11 was detected in 13 AML cases, three of them with other chromosome aberration simultaneously.23 cases of 31 patients carrying AML1-ETO or PML-RARα, reached complete remission(CR) after chemotherapy and without relapse. Conclusion Gene typing is the most precise classification method that can direct clinical treatment and evaluate prognosis. Multiplex RT-PCR technique, which can quickly screen 29 kinds of fusion gene derived from chromosome structural aberrations at one time, maybe helpful to improve M1CM classification and guide the choice of treatment.