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目的探讨Ph染色体和bcr-abl mRNA在慢性粒细胞白血病诊断、分期、治疗及微小残留病变监测中的意义。方法同时检测437份慢粒标本的Ph染色体和bcr-abl mRNA的表达情况。结果慢性期、加速期和急变期的bcr-abl mRNA定量结果逐渐增高(P<0.05);异基因造血干细胞移植后的bcr-abl mRNA定量结果随时间逐渐降低,一般在移植6月后转阴,服用格列卫与异基因造血干细胞移植病程相似,但融合基因转阴所用时间较长。结论实时定量PCR技术检测bcr-abl mRNA较Ph染色体的检测更为敏感,对于疾病分期、评价疗效、监测微小残留病变以及预测疾病进展具有重要的临床应用价值。
Objective To investigate the significance of Ph chromosome and bcr-abl mRNA in the diagnosis, staging and treatment of chronic myelogenous leukemia and the monitoring of minimal residual disease. Methods Simultaneous detection of Ph chromosome and bcr-abl mRNA expression in 437 CML specimens was performed. Results The quantitative results of bcr-abl mRNA in chronic phase, accelerated phase and blastic phase increased gradually (P <0.05). The quantitative results of bcr-abl mRNA in allogeneic hematopoietic stem cell transplantation gradually decreased with time, usually after 6 months of transplantation , Taking Gleevec and allogeneic hematopoietic stem cell transplantation similar course of disease, but the fusion gene negative longer time. Conclusion The detection of bcr-abl mRNA by real-time quantitative PCR is more sensitive than the detection of Ph chromosome. It has important clinical value for staging, evaluating curative effect, monitoring minimal residual disease and predicting disease progression.