CAJ | 학술논문

目的探讨基因扫描技术在初诊急性淋巴细胞白血病(ALL)患儿Ig/TCR基因重排克隆性分析中的作用,并探讨Ig/TCR基因重排的类型及其克隆性与ALL临床特征之问的关系.方法本研究为临床实验研究.选取2009年3月至201 1年3月广州市妇女儿童医疗中心血液肿瘤科确诊和治疗的ALL患儿86例,所有病例均经骨髓细胞形态学和流式细胞术免疫分型诊断.采用多重PCR方法检测初诊ALL患儿的4种Ig/TCR基因重排(IgH、Igκ、TCRγ和TCRδ),采用基因扫描技术对上述基因重排进行克隆特性分析.采用x2检验比较ALL患者主要临床特征在单克隆及寡克隆lg/TCR基因重排之间的差异.结果 86例初诊ALL患儿中,83例(96.5％)可检出 1种或1种以上Ig/TCR基因重排,平均每例可检出2.52个Ig/TCR基因重排；61例进行基因扫描的患儿中,56例(91.8％)可检出1种或1种以上单克隆性Ig/TCR基因重排；172个Ig/TCR基因重排中,IgH、Igκ、TCRγ和TCRδ的比例分别为27.9％、27.9％、19.8％和24.4％.单克隆、寡克隆及多克隆性的构成比分别为58.1％、30.8％和11.1％,以单克隆性重排为主.4种Ig/TCR基因重排类型的单克隆性及寡克隆性在不同临床特征间差异无统计学意义(P值均＞ 0.05).结论基因扫描可简便、快捷地分析Ig/TGR基因重排的克隆性,从而可选择其中单克隆或寡克隆者作为微小残留白血病(MRD)追踪的靶目标；ALL患儿的临床特征与Ig/TCR基因重排的类型及其克隆性无关.
목적 탐토기인소묘기술재초진급성림파세포백혈병(ALL)환인Ig/TCR기인중배극륭성분석중적작용,병탐토Ig/TCR기인중배적류형급기극륭성여ALL림상특정지문적관계.방법 본연구위림상실험연구.선취2009년3월지201 1년3월엄주시부녀인동의료중심혈액종류과학진화치료적ALL환인86례,소유병례균경골수세포형태학화류식세포술면역분형진단.채용다중PCR방법검측초진ALL환인적4충Ig/TCR기인중배(IgH、Igκ、TCRγ화TCRδ),채용기인소묘기술대상술기인중배진행극륭특성분석.채용x2검험비교ALL환자주요림상특정재단극륭급과극륭lg/TCR기인중배지간적차이.결과 86례초진ALL환인중,83례(96.5％)가검출 1충혹1충이상Ig/TCR기인중배,평균매례가검출2.52개Ig/TCR기인중배；61례진행기인소묘적환인중,56례(91.8％)가검출1충혹1충이상단극륭성Ig/TCR기인중배；172개Ig/TCR기인중배중,IgH、Igκ、TCRγ화TCRδ적비례분별위27.9％、27.9％、19.8％화24.4％.단극륭、과극륭급다극륭성적구성비분별위58.1％、30.8％화11.1％,이단극륭성중배위주.4충Ig/TCR기인중배류형적단극륭성급과극륭성재불동림상특정간차이무통계학의의(P치균＞ 0.05).결론 기인소묘가간편、쾌첩지분석Ig/TGR기인중배적극륭성,종이가선택기중단극륭혹과극륭자작위미소잔류백혈병(MRD)추종적파목표；ALL환인적림상특정여Ig/TCR기인중배적류형급기극륭성무관.
Objective To study the role of gene Scanning in the clonality analysis of Ig/TCR gene remrangement in children with newly diagnosed acute lymphoblastic leukemia (ALL),and the relationship between the clinical characteristics of ALL and the type of Ig/TCR gene rearrangement.Methods The research was the clinical experimental study.Selected 86 cases of children with ALL who were diagnosed and treated in Department of Hematology-oncology of Guangzhou Women and Children's Medical Center,and All cases were confirmed by bone marrow cell morphology and flow cytometric immunophenotyping.Used multiplex PCR to detecte Ig/TCR gene rearrangements in children with newly diagnosed ALL.Applied gene scanning to analyze the clonality of Ig/TCR gene rearrangement.Results There were 83 cases detected 1 or more than 1 types of Ig/TCR gene rearrangements in 86 cases (96.5％),with 2.52 types each case.There were 56 cases detected at least one monoclonal Ig/TCR gene rearrangement in 61 cases analyzed by gene scanning (91.8％).The detectable rate for lgH,Igκ,TCRγ and TCRδ were 27.91％,27.91％,19.77％ and 24.42％ respectively in 172 of Ig/TCR gene rearrangement.Monoclonal,oligoclonal and polyclonal composition was 58.1％,30.8％ and 11.1％ respectively,the monoclonal as the main component.There was no significant difference between the types and clonality of Ig/TCR gene rearrangement and the clinical characteristics of children with newly diagnosed ALL (P ＞ 0.05).Conclusions Gene scanning can analyze clonality of the Ig/TCR gene rearrangement conveniently and rapidly,thus,it can be possible to select the stable targets for quantitative detection of minimal residual disease minimal residual disease.There is no significant difference between the types and clonality of Ig/TCR gene rearrangement and clinical characteristics of children with newly diagnosed.