PCR扩增TCR_γ基因重排检测急性淋巴细胞白血病微量残留病的研究

USE OF THE POL YMERASE CHAIN REACTION FOR DETECTION OF MINIMAL RESIDUAL DISEASE BY AMPLIAYING TCR_γGENE REARRANGEMENT IN ACUTE LYMPHOBLASTIC LEUKEMIA

应用多聚酶链反应（ＰＣＲ）技术检测急性淋巴细胞白血病（ＡＬＬ）骨髓白血病细胞ＴＣＲγ基因重排，敏感性达１０￣（－５）水平以上。２７例急性期ＡＬＬ有２１例检测到约４００ｂｐ的扩增产物，阳性检出率为７７．８％（２１／２７）；７例完全缓解（ＣＲ）的ＡＬＬ有２例检测阳性，其中１例于检测后１．５月复发，另１例随访６个月仍ＣＲ；而其余５例检测阴性者于检测后平均随访７．１月均持续ＣＲ。提示本法对ＡＬＬＴＣＲ＿γ基因重排的检测较具普遍性，可用于其微量残留病（ＭＲＤ）的检测，对ＡＬＬ预后的判断、复发的监测可能有重要意义。

By using the polymerase chain reaction(PCR)for detection of TCR_ γgene rearrangements inacute lymphoblastic leukemia(ALL),the sensitivity was showed at above 10￣(-5)level.15 of 20patients at presentation or relapse showed rearrangements in the TCR_γlocus.the positive ratewas 75%(15/20) Among the 7 patients at complete remmision(CR),2 cases were positive,butone of them replapsed 1.5 month later,and the other remained CR during 6.0 month’s follow-up.The rest 5 cases was negative,and remained CR during the mean 7.1 months’follow-up. Ourresult suggested that TCR_γgene rearrangement detected by PCR was relatively common in ALLand this method could be used to detect minimal residual disease to evaluate the prognosis and tomonitor the relapse in ALL.