白血病患者外周血Flt3基因表达

Flt3 expression in the peripheral blood of leukemia patients

目的检测白血病患者外周血Flt3在不同类型白血病中的表达及分布情况,阐明Flt3的表达与疾病发生和发展的关系,与骨髓标本Flt3的表达作对照,确定检测外周血Flt3对白血病基因诊治的临床意义。方法采用RT-PCR方法分析34例白血病患者外周血及部分骨髓标本Flt3的表达。结果19例急性髓系白血病患者中16例阳性(84.2%),其中6例强阳性,1例化疗后完全缓解的M3患者Flt3表达阳性;6例急性淋巴细胞白血病中3例阳性(50%);5例慢性淋巴细胞白血病中2例(1例慢性期,1例急变期)阳性;2例骨髓异常综合征中1例阳性;2例急性混合细胞白血病均阳性。7例骨髓与外周血配对标本中阳性率差别无统计学意义。10例正常人表达均阴性。结论外周血可以替代骨髓作为检测Flt3表达;急非淋患者Flt3表达强弱与外周血白细胞数相关(P<0.05);Flt3表达可作为白血病基因诊断及微小残留病灶的检测标志。

Objectives To investigate the expression levels of Flt3 in the peripheral blood of leukemia patients elucidate the relationship between the expression of Flt3 gene and the pathogenesis of leukemia, and study the clinical significance of the detection of Fit3 expression in peripheral blood to the gene therapy and diagnosis of leukemia by comparing with 7 bone marrow samples. Methods RT-PCR was employed to detect the expression of Fit3 in 34 cases of peripheral blood and 7 bone marrow samples of leukemia patients. Results 16 （84.2%） positive cases were found in 19 de novo acute myeloid leukemia （AML） patients. Out of them, the expression in 6 patients were strong positive, 3 （50%） of 6 acute lymphoid leukemia （ALL） patients were positive, 2 of 5 chronic myelogenous leukemia （CML） were positive, including one patient in the chronic phase and one in the accelerated phase, 1 of 2 myelodysplastic syndrome （MDS） patients was positive, and both of 2 acute hybrid leukemia （AHL） oatients were oositive. There was no difference hetween the peripheral blood and bone marrow samples in the detection of Flt3 expression by a comparative analysis of 7 paired samples. Conclusion Instead of bone marrow, peripheral blood is a reliable material in the detection of Flt3 expression. The intensity of Flt3 expression was correlated with WBC counts in the peripheral blood （P=0. 015） of AML, MDS and AHL patients. Flt3 expression can be used as a gene symbol in the diagnosis of leukemia and the detection of minimal residual disease.