多重位点特异性PCR检测骨髓增殖性疾病五种JAK2基因突变

Multiplex sequence-specific PCR detection for simultaneous screening of 5 types of JAK2 mutations in myeloproliferative diseases

目的建立一种同时检测多种朋也基因突变的多重位点特异性PCR方法，并探讨其对骨髓增殖性疾病（MPD）的临床应用价值。方法建立同时检测JAK2 V617F突变和JAK2 exon12中K539L（包括2种基因突变）、N542-E543del和E543-D544del突变的多重位点特异性PCR方法。对115例MPD患者进行检测，包括61例真性红细胞增多症（PV）患者、43例原发性血小板增多症（ET）患者和11例原发性骨髓纤维化（MF）患者。结果建立的PCR方法可以同时检测上述5种朋怨基因突变，可以检测出1％的JAK2 V617F突变型等位基因，对其他几种突变可检测出0．1％的突变型等位基因。在61例PV患者中，检测出JAK2 V617F突变56例JAK2 exon12突变3例；在43例ET患者中，检测出JAK2 V617F突变27例，未检测到JAK2 exon12突变；在11例MF患者中，检测到JAK2 V617F突变6例，未检测到JAK2 V617F突变。3例JAK2 exon12突变的患者临床表现为血红蛋白增多，内源性红系集落生成阳性，但白细胞和血小板增多不明显，不伴脾肿大。结论多重位点特异性PCR方法检测灵敏度高，可联合检测5种JAK2基因突变，能有效提高突变检出率。

Objective To develop a multiplex sequence-specific PCR assay for simultaneous screening of 5 types of JAK2 mutations and investigate its clinical application value. Methods Multiplex sequence-specific PCR assay for simultaneous screening of JAK2 V617F, K539L （ include 2 types of gene mutations ）, N542-E543del and E543-D544del mutations were developed. 115 patients with myeloproliferative diseases （MPD） including 61 polycythemia vera （PV） cases, 43 essential thrombocythemia （ET） cases and 11 primary myelofibrosis （MF） cases were analyzed. Results The assay can screen the 5 types of JAK2 mutations efficiently. The detection sensitivity is 1% for JAK2 V617F mutation and 0. 1% for the other mutations. JAK2 V617F mutation and JAK2 exon12 mutation were detected in 56 and 3 of the 61 PV samples, respectively. 27 of the 43 ET samples and 6 of the 11 MF samples were JAK2 V617F positive, but no JAK2 exon12 mutation was found in both groups. The 3 cases carrying JAK2 exon12 mutation had the clinical feature of erythrocytosis and erythropoietin-independent erythroid colony formation but without apparent leukocytosis, thrombocytosis and splenectasis. Conclusion The assay can simultaneously screen 5 types of JAK2 mutations with high sensitivity and thus lead to an increased detection rate.