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 i
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]
