急性白血病病人骨髓EB病毒DNA检测及临床意义

DETECTION OF EB VIRUS DNA AND ITS CLINICAL SIGNIFICANCE IN PATIENTS WITH ACUTE LEUKEMIA

目的对EB病毒(EBV)与急性白血病(AL)临床诊断及染色体核型改变的相关性进行初步分析。方法采用巢式聚合酶链反应(PCR),对50例急性髓细胞白血病(AML)病人、34例急性淋巴细胞白血病(ALL)病人和20例健康人(正常对照组)骨髓细胞EBV-DNA进行检测,采用R显带技术对所有病人进行染色体核型分析。结果 ALL组、AML组和正常对照组EBV的阳性率分别为58.8%(20/34)、34.0%(17/50)和10.0%(2/20),3组间EBV阳性率比较差异有显著性(χ2=13.3,P<0.05),其中AML组与ALL组、正常对照组EBV阳性率比较差异无显著性(χ2=5.1、4.2,P>0.0167),ALL组EBV阳性率高于正常对照组(χ2=12.4,P<0.0167)。染色体分析显示,64.7%(22/34)的ALL病人和40.0%(20/50)的AML病人检测到异常核型,ALL组异常核型的检出率明显高于AML组(χ2=4.94,P<0.05)。37例EBV阳性的病人有23例染(62.2%)色体异常,而47例EBV阴性的病人中有19例(40.4%)染色体异常,EBV阳性病人染色体异常核型的检出率明显高于EBV阴性病人(χ2=3.9,P<0.05)。结论 EBV感染可能与ALL病人染色体核型改变及发病有相关性。

Objective To analyze the correlation between Epstein Barr virus（EBV）and clinical diagnosis of acute leukemia（AL）,as well as the association between EBV and its chromosomal changes. Methods Nested polymerase chain reaction（PCR）was used to detect EBV-DNA in 50 cases of acute myeloblastic leukemia（AML）,34 cases of acute lymphocytic leukemia（ALL）and 20 cases of healthy control group.Karyotyping was performed in AL patients by R-banding. Results The positive rate of EBV in ALL,AML patients and healthy controls was 58.8%（20/34）,34.0%（17/50）and 10.0%（2/20）,respectively,the difference of EBV positive rate among the three groups was significant（χ^2=13.3,P〈0.05）,of which,the difference between AML group and ALL group as well as healthy control group was no significant difference（χ^2=5.1,4.2;P〈0.0167）,in ALL group,the positive rate of EBV was higher than that in the healthy group（χ^2=12.4,P〈0.0167）.Chromosome karyotype analysis showed that abnormal karyotype was detected in 64.7%（22/34）of patients with ALL and 40.0%（20/50）of those with AML,its detection rate being higher in ALL versus AML（χ^2=4.94,P〈0.05）.Chromosomal abnormalities were detected in 23 of 37（62.2%）patients with EBV positive,while in 19 of 47（40.4%）with EBV negative,the detection rate of chromosome abnormalities was higher in patients of EBV positive than that of EBV negative（χ^2=3.9,P〈0.05）. Conclusion EBV infection is likely to be associated with chromosome changes and morbidity in patients with acute lymphocytic leukemia.