【摘要】 目的探讨bcr/abl融合基因检测在诊断慢性粒细胞性白血病(CML)和监测CML残留病灶中的意义。方法采用巢式逆转录PCR(RT-PCR)检测337例CML患者bcr/abl融合基因的表达,并对所有患者进行残留病灶的动态监测,共检测632人次。其中移植(包括外周血干细胞移植、骨髓移植和脐血移植)患者26例;服用格列卫的患者22例;其它治疗方案患者289例。结果在337例CML初诊患者中bcr/abl基因表达阳性者325例,阳性率为96.4%;其中b3a2型转录本占58.5%(190/325),b2a2型转录本占41.2%(134/325),b3a3型转录本占0.3%(1/325)。未发现b2a3型转录本。移植患者bcr/abl融合基因转阴率为88.5%(23/26),时间在30~201 d之间,中位数为55 d;服用格列卫患者融合基因总转阴率59.1%(13/22),转阴时间在用药后90~365d之间,中位数为210 d;其它治疗组患者转阴12例,转阴率为4.1%(12/289)。结论bcr/abl融合基因的检测及动态观察,对CML的临床诊断、疗效及预后判断具有重要意义。更多还原

【Abstract】 Objective To explore the significance of bcr/abl fusion gene in the diagnosis and the minimal residue disease monitoring CML.Methods The bcr/abl fusion gene mRNA levels of 337 CML patients were detected by RT-PCR.632 samples were detected by the same method for monitoring the MRD of all patients.26 patients,22 patients and 289 patients weredivided into three different groups(allo-HSCT,STI571 and other therapy regimens)respectively.Results The bcr/abl fusion genes were checked out in 325 patients of total 337 CML patients,and the positive ratio was 96.4%.Three transcripts,b3a2,b2a2 and b3a3 were found in all patients,the proportionwas 58.5%,41.2% and 0.3% respectively.88.5%,59.1% and 4.1% patients in three different groups had negative bcr/abl fusion gene results after variable regimens respectively.The negative results were checked out in day 30 to day 201,median day 55 in the allo-HSCT group,and in day 90 to 365,median day 210 in theSTI571 group.Conclusion Detection and continuous monitoring of bcr/abl fusion gene have great significances in the diagnosis,the evaluation of treatment effect and the prognosis of CML patients.更多还原