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①目的探讨急性淋巴细胞白血病（ＡＬＬ）微量残留病（ＭＲＤ）检测的临床意义。②方法应用筑巢式多聚酶链反应（ｎｅｓｔｅｄＰＣＲ）对３２例ＡＬＬ进行Ｔ细胞受体（ＴＣＲ）Ｖδ２Ｄδ３基因重排检测。③结果１８例Ｂ系ＡＬＬ中有１５例（７２．２％）、４例Ｔ系ＡＬＬ中有１例（２５．０％）存在ＴＣＲＶδ２Ｄδ３基因重排。同时对１６例进行３９例次微量残留病动态监测，其中６例ＭＲＤ－ＰＣＲ阴性病人随访５．１７～１６．１７年，无１例复发；１０例ＭＲＤ－ＰＣＲ阳性者，２例分别于阳性后０．２５，１．００年骨髓复发，１例有复发倾向，余７例随访４．３３～６．２５年无复发。④结论ＭＲＤ－ＰＣＲ阴性者预后良好，可望长期生存，治疗时应以ＭＲＤ－ＰＣＲ转阴为停止化疗的可靠指标，对ＭＲＤ－ＰＣＲ阳性者应定期监测ＭＲＤ变化，结合病人情况进行综合评价。
Objective To investigate the clinical significance of detection of minimal residual disease (MRD) in acute lymphoblastic leukemia (ALL). 2 Methods Nested polymerase chain reaction (nested PCR) was used to detect T cell receptor (TCR) Vδ2Dδ3 gene rearrangement in 32 ALL patients. 3 Results There were 15 cases (72.2%) of 18 B-ALL patients and 1 (25.0%) of 4 T-ALL patients had TCRV?2D?3 gene rearrangement. At the same time, dynamic monitoring of 39 cases of minor residual disease was performed in 16 cases, of which 6 cases of MRD-PCR negative patients were followed for 5.17-16.17 years. No recurrence occurred in 10 cases; 10 cases were positive for MRD-PCR, and 2 cases were positive respectively. After 0.25, 1.00, the bone marrow relapsed. One patient had relapse tendency. The remaining 7 patients had no recurrence from 4.33 to 6.25 years of follow-up. 4 Conclusions MRD-PCR-negative patients have good prognosis and are expected to survive for a long time. MRD-PCR should be used as a reliable indicator of cessation of chemotherapy during treatment. MRD-PCR positive patients should be monitored regularly for changes in MRD, and combined with the patient’s condition for comprehensive evaluation.