应用多重RT-PCR结合寡核苷酸芯片方法检测儿童白血病常见融合基因

Identification of Gene Rearrangements in Childhood Leukemia by Using a Multiplex Polymerase Chain Reaction-Microarray Approach

本研究探讨基因芯片在儿童白血病8种常见融合基因检测中的应用。采用多重巢式RT-PCR结合寡核苷酸芯片方法对84例临床收集的白血病标本进行融合基因检测。结果表明:此芯片可以从患者骨髓样本RNA中准确检测到阳性参照序列以及与融合基因相对应的特异基因片段。84例白血病患者骨髓标本中,31例(36.90%)具有8种染色体结构畸变产生的融合基因。包括tel/aml1、e2a/pbx1、bcr/ablp190、bcr/ablp210、mll/af4、aml1/eto、pml/rarα、cbfβ/myh11。芯片检测的敏感性及特异性和RT-PCR方法相当。结论:采用多重巢式RT-PCR结合寡聚核苷酸芯片方法,可快速并同时筛选出8种染色体结构畸变产生的融合基因,为儿童白血病危险分层、治疗选择、预后判断提供重要依据。此种方法应用于筛查初治白血病儿童融合基因表达时优缺点并存,具有一定临床实用价值。

The aim of study was to investigate the application of a novel microarray approach for the eight most common leukemia translocations in children for routine molecular diagnostic hematopathology practice. Bone marrow samples from 84 children with leukemia were analyzed by multiplex nested RT-PCR combined with oligonucleotide microarray. The results showed that out of 84 leukemic samples, 31 （ 36. 90 % ） carried 8 types of fusion genes including tel/am11, e2a/pbx1, bcr/ablp190, bcr/ablp210, m11/af4, amll/eto, pml/raα, cbfβmyh11. The sensitivity and specificity of the assay is comparable with the RT-PCR technique. In conclusion, this multiplex nested RT-PCR could quickly screen 8 types of chromosome structural aberrations at the same time. It can provide reliable and helpful information for risk stratification, therapy evaluation and prognosis prediction in childhood leukemia. There are both advantages and disadvantages in applying this new method. The microarray-based assay will be an effective and reliable tool in the clinical screening of leukemia patients for the presence of specific gene rearrangements with important diagnostic and prognostic implications.