qPCR检测慢性粒细胞性白血病细胞中BCR-ABL mRNA的表达及其意义

摘要

目的 探讨实时荧光定量PCR(qPCR)检测BCR-ABL mRNA对慢性粒细胞性白血病(CML)患者异基因造血干细胞移植(allo-HSCT)后体内微小残留病(MRD)的早期预测和监测价值.方法 选取2013年1月至2016年1月在深圳市盐田区人民医院、深圳大学医学院及北京大学深圳医院门诊和血液科住院的CM L患者67例作为观察组,同期深圳市盐田区人民医院体检健康人群50例为对照组,用qPCR检测CML患者异基因造血干细胞移植前后BCR-ABL mRNA水平.结果 对照组健康人群BCR-ABL mRNA检测均为阴性.移植前加速期和急变期的CML患者BCR-ABL mRNA水平高于慢性期,差异有统计学意义(P<0.05);移植后,前36个月各时间点qPCR检测的BCR-ABL/ABL 比值均较移植前明显下降,差异有统计学意义(P<0.05);移植36个月后qPCR仍然能检测出BCR-ABL/ABL 的表达水平.结论 qPCR方法准确可靠,对于临床诊断CM L 和M RD的检测具有重要的临床应用价值.%Objective To investigate the early prediction and monitoring value of real time fluorescence quantitative PCR(qPCR) detection of BCR-ABL mRNA on chronic myelogenous leukemia(CML)patients with minimal residual disease(MRD)after alloge-neic hematopoietic stem cell transplantation(allo-HSCT).Methods From January 2013 to January 2016 in People's Hospital of Yantian District,School of Medicine in Shenzhen University and Shenzhen Hospital of Peking University,67 cases of outpatient and hospitalized patients with chronic myelogenous leukemia in the Department of Hematology were selected as the observation group, and 50 healthy people who took physical examination in the People's Hospital of Yantian District at the same period of time were se-lected as the control group.BCR-ABL mRNA levels before and after allogeneic hematopoietic stem cell transplantation in patients with chronic myelocytic leukemia were detected by qPCR.Results The BCR-ABL mRNA results in the control group were nega-tive.Before transplantationin the levels of BCR-ABL mRNA in patients with CML in accelerated and blastic phase were higher than that in patients in chronic phase(P<0.05);After transplantation the BCR-ABL/ABL ratio of qPCR detected at all time points in the first 36 months was significantly lower than that before the transplantation,and the difference was statistically significant(P<0.05);qPCR can still detect the level of BCR-ABL/ABL expression after 36 months of transplantation.Conclusion qPCR is accu-rate and reliable,and has important clinical application value for the clinical diagnosis of chronic myeloid leukemia and minimal re-sidual disease detection.