Objective To evaluate the value of detection of fusion genes of bcr/abl, PML/RARa, and AML/ETO by nested reverse transcriptase polymerase chain reaction (nested RF-PCR) in the diagnosis,treatment, and prognosis of leukemia. Methods The fusion genes of bcr/abl, PML/RAR, and AML/ETO were detected by nested RF-PCR in 231 patients with leukemia, and the cytomophology and clinical turnover were analyzed. Results The positive rate of fusion gene of bcr/abl was 84.0％ (79/94) in chronic myelocytic leukemia (CML) and was 36.4％ (20/55) in acute lymphoblastic leukemia (ALL); while that of fusion gene of PML/RARa was 58.0％ (29/58) in acute promyelocytic leukemia (APL); and that of fusion gene of AML/ETO were 28.2％ (9/32) in acute myelocytic leukemia M2 (AML-M2). Conclusion Nested RT-PCR is a rapid,sensitive, and precise method for detecting fusion genes of leukemia, and can provide molecular biological basis for diagnosis of leukemia and can be one of the index of minimal residual disease.%目的:探讨巢式逆转录聚合酶链反应(巢式RT-PCR)动态检测白血病bcr/abl、PML/RARa及AML/ETO融合基因在白血病诊断、治疗、预后判断的价值.方法: 应用巢式PCR法对231例急慢性白血病患者bcr/abl、PML/RARa及AML/ETO融合基因作检测,同时结合患者细胞形态学及临床转归予以分析.结果:94例慢性粒细胞白血病患者中,79例bcr/abl融合基因阳性,阳性率为84.0 %;55例急性淋巴细胞白血病患者中,20例bcr/abl融合基因阳性,阳性率为36.4%;50例急性早幼粒细胞白血病患者中,29例PML/RARa融合基因阳性,阳性率为58.0 %;32例急性粒细胞白血病M2患者中,9例AML/ETO融合基因阳性,阳性率为28.2%.结论:巢式PCR是一种快速、敏感而准确的检测方法,可为白血病患者提供分子生物学的诊断依据,并可作为微小残留病的监测指标之一.
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