PCR-SSCP分析急性淋巴细胞白血病TCR基因寡/亚克隆重排及临床意义

The study of oligoclonal/subclonal rearrangement of TCR gene in acute lymphoblastic leukemia with PCR-SSCP and it′s clinical significance

目的 为研究急性淋巴细胞白血病 (ALL)TCR基因寡 /亚克隆重排及与临床关系。方法 采用PCR SSCP技术分析 81例ALLTCRVγⅠ Jγ基因重排。结果 65例 ( 80 .2 % )ALL病人存在TCRVγⅠ Jγ基因重排 ,8例 ( 8.6% )病人存在寡 /亚克隆重排 ;寡 /亚克隆ALL的白细胞计数显著高于非寡 /亚克隆ALL(P <0 .0 1 ) ;寡 /亚克隆ALL的完全缓解率为 3 7.5% ,显著低于非寡 /亚克隆ALL( 80 .7% ) (P <0 .0 0 5)。结论 应用PCR SSCP方法可确定ALL的寡 /亚克隆性 ,ALL病人寡 /亚克隆检测有助于预测疗效和预后判断。

Objective To study the oligoclonal/subclonal rearrangement of T cell receptor (TCR) gene in the patients of acute lymphoblastic leukemia (ALL) and its relationship to the clinical characteristics. Methods TCR VγⅠ Jγ gene rearrangement were detected in 81 cases by polymerase chain reaction (PCR) and single strand conformation polymorphism (SSCP). Results 65 cases (80.2%) were found with TCR VγⅠ Jγ gene rearrangement and 8 cases (8.6%) showed oligoclonal/subclonal rearrangement. The leucocyte count were higher in ALL patients with oligoclonal/subclonal rearrangement than the ALL patients without oligoclonal/subclonal rearrangement ( P <0.01). 37.5% oligoclonal/subclonal rearrangement ALL patients achieved complete remission, which was significantly lower than that (80.7%) in ALL case without oligoclonal/subclonal rearrangement. Conclusion Detection of TCR γ gene rearrangement by PCR SSCP can identify oligoclonality/subclonality in ALL patients and oligoclonal/subclonal rearrangement was potential in predicting prognosis of ALL.