PCR扩增IgH和TCR_β基因重排在检测淋巴细胞白血病微小残留病中的应用

Application of PCR in detection of IgH and TCR gene rearrangement in MRD

利用ＩｇＨ和ＴＣＲ＿β克隆性基因重排原理，用多聚酶链反应（ＰｏｌｙｍｅｒａｓｅＣｈａｉｎＲｅａｃｔｉｏｎ．ＰＣＲ）技术检测小儿急性淋巴细胞白血病（ＡＬＬ）骨髓和外周血共１３例。结果：ＡＬＬ初治的２例患儿ＰＣＲ检测全部呈现阳性特异性单带。ＡＬＬ完全缓解（ＣＲ）的１１例患儿中阳性７例，阴性４例，其中２例骨髓移植（ＢＭＴ）患儿移植前ＰＣＲ阳性，移植后转为阴性。１例自体骨髓移植（ａｕｔｏ－ＢＭＴ）患儿于移植后２个月时ＰＣＲ检测又重新出现阳性，但临床无复发现象。４例对照者ＰＣＲ均为阴性。结果表明ＰＣＲ技术具有简便、快速、敏感、特异性强等优点，在检测微小残留（ＭＲＤ）中具有广阔前景。

PCR technique was used to detect clonal rearrangement of IgH and TCR genes in DNA samples frombone marrow and peripheral blood of 13 children suffering from acute lymphoblastic leukemia (ALL).Apositive specific single band was observed in 2 patients of ALL without treatment. 7 out of 11 ALL in com-plete remission(CR)stage were also positive and 4 cases were negetive. 2 out of these 11 cases were previ-ously positive before treatment by bone marrow transplantation(BMT),and 1 case showed positive resultafter two months of auto-BMT without any symptom of recurrence. ALL 4 controls were negetive. Ourresults indicate that the PCR technique is simple,fast,sensitive and highly specific. It is very useful in thedetection of minimal residual disease(MRD).