急性粒细胞白血病TCRγ基因重排的检测及其意义

A STUDY ON T CELL RECEPTOR GAMMA GENE REARRANGEMENT IN ACUTE MYELOID LEUKEMIA

①目的 探讨急性粒细胞白血病 (AML)中T细胞抗原受体γ链 (TCRγ)基因重排的发生情况及其与AML临床特征的关系。②方法 以构建的TCRγ基因片断为内参照模板 ,用聚合酶链反应 (PCR)法扩增TCRγ基因重排片断。③结果 TCRγ基因重排在AML中发生率为 2 4 .4 % ,在急性单核系白血病中发生率高达 4 8.1% ,差异有极显著性 (χ2 =12 .32 ,P <0 .0 0 1)。有TCRγ基因重排的AML病人的外周血白细胞计数高于无TCRγ基因重排的AML病人 (t=2 .5 35 ,P <0 .0 5 ) ;有TCRγ基因重排的AML病人的肝大程度大于无TCRγ基因重排的AML病人 (t=2 .35 7,P <0 .0 5 ) ;TCRγ基因重排阳性的AML病人达到第 1次缓解的时间长于TCRγ基因重排阴性的AML病人 (t=2 .5 32 ,P <0 .0 5 )。④结论 TCRγ基因重排可发生于部分髓系白血病病人 ,急性单核系白血病的发生率最高 ,这部分病人临床体征明显 ,对标准化疗不敏感 ,不易获得缓解。

Objective\ To investigate the incidence of T cell receptor gamma (TCRγ) gene rearrangement in acute myeloid leukemia (AML) and to study the relationship between the TCRγ gene rearrangement and the clinical features of AML. Methods\ TCRγ gene rearrangement was detected with polymerase chain reaction. \ Results\ The incidence of TCRγ gene in AML was 24.4% , and the high incidence(48.1%) was found in the subtype of acute monogenous leukemia. The difference was significant( χ 2= 12.32 , P <0.001). Compared with the negative cases, higher count of white blood cell in peripheral blood ( t= 2.535 ,P <0.05), enlargement of the liver ( t= 2.357 , P< 0.05), and longer time to achieve complete remission( t=2.532, P < 0.05 ) were found in positive TCRγ cases. \ Conclusion\ TCRγ gene rearrangement could occur in AML .Acute monogenous leukemia has high incidence of TCRγ gene rearrangement .The cases with TCRγ gene have obvious clinical symptoms and are insensitive to standard chemotherapy and difficult to achieve CR.