摘要
目的探讨实时荧光定量聚合酶链反应(qRT-PCR)法监测慢性髓系白血病(CML)外周血BCR-ABL融合基因水平的价值。方法选取2016年3月～2017年6月我院血液科收治的CML患者35例,应用qRT-PCR法检测患者的BCR-ABL融合基因水平,并监测不同疾病分期患者BCR-ABL转录水平,动态监测不同BCR-ABL融合基因水平组患者伊马替尼的治疗效果及无病生存期(DFS),患者治疗前后的BCR-ABL转录水平变化。结果急变期患者的BCR-ABL转录本水平明显高于加速期和慢性期,加速期患者的BCR-ABL转录本水平明显高于慢性期,组间两两比较差异均有统计学意义(F=4.68,P=0.00)。疗效满意方面:低水平组与中水平组患者比较,差异无统计学意义(P>0.05),但两组均明显高于高水平组,差异有统计学意义(P<0.05);中位DFS方面:BCR-ABL融合基因低水平组患者的中位DFS明显长于中水平组、高水平组,中水平组的中位DFS明显长于高水平组,组间两两比较差异均有统计学意义(F=36.15,P=0.00)。伊马替尼靶向治疗第3、6、12个月后的BCR-ABL转录本水平均明显低于治疗前(P=0.00);通过伊马替尼靶向治疗,患者的BCR-ABL转录本平明显降低,但前6个月的下降幅度最明显。结论 qRT-PCR技术可准确地监测患者外周血BCR-ABL融合基因水平,有利于辅助CML患者疾病的诊断和病情分期,同时,通过对CML患者不同时期外周血BCR-ABL融合基因水平的动态监测有利于准确评估患者的治疗效果和预后,对CML患者治疗方案的选择具有重要指导意义。
Objective To investigate the value of quantitative real-time polymerase chain reaction(qRT-PCR)method monitoring the BCR-ABL fusion gene level in peripheral blood of chronic myeloid leukemia(CML).Methods A total of 35 patients with CML treated in our department of hematology from March 2016 to June 2017 were selected.The BCR-ABL fusion gene level was detected by qRT-PCR in patients.The transcriptional level of BCR-ABL in patients with different disease stages were monitored.The therapeutic effect and disease-free survival(DFS)of Imatinib in patients with different BCR-ABL fusion gene level were monitored dynamically.The transcriptional levels of BCR-ABL in patients before and after treatment were also monitored.Results The transcriptional level of BCR-ABL in patients with acute phase was significantly higher than that in patients with accelerated phase and chronic phase.The transcriptional level of BCR-ABL in patients with accelerated phase was significantly higher than that in patients with chronic phase,and there were significant differences between the two groups(F=4.68,P=0.00).In terms of curative effect satisfaction,there was no significant difference between the low-level group and the middle-level group(P>0.05),but the two groups were significantly higher than the high-level group(P<0.05).In terms of median DFS,the middle DFS of BCR-ABL fusion gene in the low-level group was significantly longer than that of the middle-level group and the high-level group,the median DFS in the middle-level group was significantly longer than that in the high-level group,and there were significant differences between the two groups(F=36.15,P=0.00).BCR-ABL transcripts level after Imatinib targeted therapy at 3,6 and 12 months were significantly lower than those before treatment(P=0.00).BCR-ABL transcripts level were significantly lower in patients with Imatinib targeted therapy,but the most significant decrease was in the first six months.Conclusion qRT-PCR technology can accurately monitor the level of BCR-ABL fusion gene in peripheral blood of patients,which is helpful to assist the diagnosis and stage of disease in patients with CML.At the same time,dynamic monitoring BCR-ABL fusion gene level in peripheral blood of CML patients at different stages is helpful to accurately evaluate the therapeutic effect and prognosis of patients,and has important guiding significance for the selection of treatment options for patients with CML.
作者
陈喜填
夏维林
郑小玲
吴桂香
CHEN Xi-tian;XIA Wei-lin;ZHEN Xiao-ling;WU Gui-xiang(Department of Hematology,People′s Hospital of Jieyang City,Guangdong Province,Jieyang 522000,China)
出处
《中国当代医药》
2019年第1期11-15,共5页
China Modern Medicine
基金
广东省揭阳市医学科学技术研究立项[揭市卫(2017)67号]
