两种方法动态监测急性早幼粒细胞白血病微小残留病变的前瞻性比较研究

Prospective Study on Comparing Two Methods for Dynamic Monitoring of Minimal Residual Disease in Acute Promyelocytic Leukemia

本研究对比聚合酶链式反应(PCR)和多参数流式细胞术(FCM)在急性早幼粒细胞白血病(APL)患者微小残留病变(MRD)动态监测中的价值。2011年1月至2012年12月,在我院接受巩固治疗的APL患者,均于化疗前行骨髓穿刺,每例留取3份标本,同时行骨髓细胞形态学检查、融合基因PCR和FCM检查,并对结果进行统计分析。对48例入选患者共检查159例次,留取标本477份。结果表明:骨髓细胞形态学检查发现3份复发,余均为完全缓解;PCR检查中阳性7份,FCM检查中阳性19份(kappa检测,P>0.05)。结论:FCM与PCR检查对APL治疗效果的评估价值相似。

This study was purposed to comparatively analyse the value of PCR and FCM for dynamic monitoring minimal residual disease （MRD） of acute promyelocytic leukemia.The patients with acute promyelocytic leukemia hospitalized in our hospital from January 2011 to December 2012 were observed and all achieved complete remission after remission induction therapy.Before the chemotherapy,the bone marrow cell morphology examination,polymerase-chain reaction （PCR） and multi-parameter flow cytometry （FCM） were performed for each patient.Then the detection results were statistically analyzed.The 477 specimens were achieved from 159 detections for 48 patients.The results showed that 3 specimens were found to be relapsed by bone marrow cell examination,and other specimens were complete remission ;PCR detection confirmed 7 positive,and the FCM confirmed 19 positeve.There wasn＇t significant difference between PCR and FCM by kappa test （P ＞ 0.05）.It is concluded that FCM is as sensitive as PCR in evaluating the treatment effect of acute promyelocytic leukemia.