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目的:探讨以降钙素基因高度甲基化为白血病克隆的分子基因标志,检测白血病微量残留病,并预测预后的可能性。方法:用限制性内切酶消化 DNA,应用多聚酶链反应(PCR)技术检测29例急性白血病和8例慢性粒细胞白血病急变患者的降钙素基因的甲基化程度。对降钙素基因高度甲基化阳性者,以降钙素基因高度甲基化为白血病克隆的分子基因标志,应用PCR技术定期追踪检测骨髓微量残留病。结果:20例白血病完全缓解后均存在微量残留病。完全缓解后微量残留病持续阳性或转阴后再次出现阳性,提示将发生骨髓复发,能提早2～11个月预示疾病的复发。微量残留病较早转阴并持续长期阴性者可能获得长期生存。结论:以降钙素基因高度甲基化为白血病克隆的分子基因标志,应用PCR 技术能起到监测白血病骨髓微量残留病的作用,为预测白血病的预后开辟了一条新途径。
OBJECTIVE: To investigate the molecular genetic markers cloned with high methylation of calcitonin gene into leukemia, to detect leucocyte micro-residual disease and to predict the possibility of prognosis. Methods: DNA was digested with restriction endonucleases and the degree of methylation of calcitonin gene in 29 patients with acute leukemia and 8 patients with chronic myeloid leukemia was detected by polymerase chain reaction (PCR). For those with highly methylated calcitonin gene, hypermethylation of calcitonin gene was used as the molecular gene marker for leukemia clones, and the bone marrow micro-residual disease was tracked regularly by PCR. Results: There were trace residual disease after 20 cases of leukemia were completely relieved. After complete remission, micro-residual disease continued to be positive or negative again after the positive, suggesting the occurrence of bone marrow recurrence, can be 2 to 11 months earlier heralding the recurrence of the disease. Trace residual disease earlier negative and long-term negative may be long-term survival. CONCLUSION: PCR is a molecular marker for cloning leukemia with highly methylated calcitonin gene, which can be used to monitor the residual disease of bone marrow in leukemia. It provides a new way to predict the prognosis of leukemia.