bcr-abl融合基因在慢性粒细胞白血病诊治中的意义

Diagnostic and clinical significance of detecting bcr-abl gene in chronic myeloid leukemia

目的探讨定量检测bcr-abl融合基因在慢性粒细胞白血病(CML)诊断、治疗及微小残留病变监测中的意义。方法应用实时定量PCR(RQ-PCR)方法检测145例CML患者bcr-abl融合基因的表达情况。结果abl和bcr-abl的标准曲线相关系数均大于0.99,批内差及批间差均小于4%;11例不同分期的CML患者同时检测外周血和骨髓中bcr-abl水平,8例外周血较骨髓低,3例较骨髓高;急变期的bcr-abl表达情况较加速期和慢性期均明显增高。结论RQ-PCR技术检测bcr-abl融合基因准确可靠,对于评价疗效、监测微小残留病变以及预测疾病进展具有重要的临床应用价值。

Objective To evaluate the significance of bcr-abl mRNA expression to diagnose, treat and monitor minimal residual disease in myeloid leukemia （CML）. Methods Ber-abl mRNA level of 145 CML patients were detected by realtime quantitative RT-PCR （RQ-PCR）. Results Both correlation coefficiencies were over 0.99 for abl and bcr-abl standard curves. Coefficiencies of both interassay and iutraassay variation were below 4%. Detecting bone marrow samples and blood samples of 11 CML cases, levels of bcr-abt expression in 8 patients were lower in blood samples than bone marrow samples, and 3 cases showed higher levels in blood samples. Expression of bcr-abl in blastic phase （BP） was markedly higher than in accelerated phase （AP） and chronic phase （CP） （ P 〈 0. 01 ）. Conclusion RQ-PCR is reliable to detect bor-abl gene, which can be used to evaluate the treatment outcome, monitor the minimal residual disease, and predict blast crisis.