流式细胞术与不同类型聚合酶链式反应技术用于儿童急性淋巴细胞白血病微小残留病监测的比较

doi:10.3969/j.issn.1671-7171.2021.04.026

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1249 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 【目的】 比较流式细胞术(FCM)与多种聚合酶链式反应(PCR)技术在儿童急性淋巴细胞白血病微小残留病(MRD)监测中的应用价值。【方法】 选择2016年1月至2018年12月本院收治的170例急性淋巴细胞白血病患儿,且均接受SCCLG-ALL-2016方案治疗。在初诊时通过FCM行免疫分型检测以及通过PCR技术检测急性淋巴细胞白血病融合基因和免疫球蛋白(Ig)及T细胞表面受体(TCR)基因重排;治疗d₁₅通过FCM及不同类型PCR技术(RT-qPCR、巢式RT-PCR、多重PCR)进行MRD监测。分析FCM与不同类型PCR技术对MRD监测结果有无差异。【结果】 FCM检测MRD阳性率较RT-qPCR和巢式RT-PCR高,但差异无统计学意义(P>0.05)。FCM检测MRD阳性率较多重PCR高,且其差异具有统计学意义(χ²=34.03,P<0.05)。RT-qPCR、巢式RT-PCR及FCM技术检测MRD阳性患者均较阴性患者OS低,但其差异无统计学意义(P>0.05)。多重PCR技术检测MRD阳性患者较阴性患者OS低,差异有统计学意义(P<0.005)。【结论】 FCM方法与RT-qPCR或巢式RT-PCR技术检测白血病特异性融合基因均适用于急性淋巴细胞白血病患儿MRD监测,灵敏度高,特异性强;多重PCR方法检测IG或TCR基因重排进行MRD监测,特异性强,但灵敏度较低。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	宋娜
	旷文勇

关键词 ：前体细胞淋巴母细胞白血病淋巴瘤/诊断, 流式细胞术/方法, 多重聚合酶链式反应/方法, 肿瘤, 残余, 儿童

Abstract：【Objective】 To compare the application of flow cytometry (FCM) and polymerase chain reaction (PCR) in monitoring minimal residual disease (MRD) in children with acute lymphoblastic leukemia. 【Methods】 170 patients diagnosed with acute lymphoblastic leukemia in Hunan children's Hospital from January 2016 to December 2018 were collected, and all of them received therapy with SCCLG-ALL-2016 protocol. All patients were detected immunophenotyping by flow cytometry, and detected fusion genes and immunoglobulin (IG) and T cell receptor (TCR) gene rearrangement by PCR at the initial diagnosis. On the 15th day of treatment, MRD was monitored by FCM and different types of PCR (real-time quantitative PCR,RT-qPCR), multiplex PCR and nested RT-PCR). To analyze the differences of MRD monitoring results between FCM and different types of PCR. 【Results】 The positive rate of MRD detected by FCM was higher than that by RT qPCR and nested RT-PCR, but the differences were not statistically significant(P>0.05). The positive rate of MRD detected by FCM was higher than that by multiplex PCR, and the difference was statistically significant (χ²=34.03,P=0.000). OS of MRD positive patients detected by RT-qPCR, nested RT-PCR and FCM was lower than negative patients, but the difference was not statistically significant (P>0.05). OS of MRD positive patients detected by multiplex PCR was lower than negative patients, and the difference was statistically significant (P=0.002). 【Conclusion】 Technique of FCM and RT-qPCR or nested RT-PCR are both useful to monitor MRD level in pediatric ALL,sensitively.The sensitivity of multiplex PCR in MRD is lower than that of FCM.Multiplex PCR detecting IG or TCR gene rearrangement for MRD monitoring has high specificity but low sensitivity.

Key words： Precursor Cell Lymphoblastic Leukemia-Lymphoma/DI Flow Cytometry/MT Multiplex Polymerase Chain Reaction/MT Neoplasm, Residual Child

收稿日期: 2021-03-09

中图分类号:

R733.71

引用本文:

宋娜, 旷文勇. 流式细胞术与不同类型聚合酶链式反应技术用于儿童急性淋巴细胞白血病微小残留病监测的比较[J]. 医学临床研究, 2021, 38(4): 569-571.
SONG Na, KUANG Wen-yong. Comparision of FCM and Different Types of PCR Techniques in the Monitoring of Small Residual Disease in Children with Acute Lymphocytic Leukemia. JOURNAL OF CLINICAL RESEARCH, 2021, 38(4): 569-571.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.04.026 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I4/569

[1] PUI C H, EVANS W E.Treatment of acute lymphoblastic leukemia[J].N Engl J Me,2012,360(2): 166-178.
[2] THEUNISSEN P, MEJSTRIKOVA E, SEDEK L, et al.Standardized flow cytometry for highly sensitive MRD measurements in B-cell acute lymphoblastic leukemia[J].Blood,2017,129( 3) : 347-357.
[3] CONTER V. Molecular response to treatment redefines all prognostic factors in children and adolescents with B-cell precursor acute lymphoblastic leukemia: results in 3184 patients of the AIEOP-BFM ALL 2000 study[J].Blood, 2010, 115(16):3206-3214.
[4] VAN DONGEN J J. Minimal residual disease diagnostics in acute lymphoblastic leukemia: need for sensitive, fast, and standardized technologies[J].Blood,2015, 125(26): 3996-4009.
[5] BASSAN R, SPINELLI O. Minimal residual disease monitoring in adult ALL to determine therapy[J].Curr Hematol Malig Rep,2015, 10(2): 86-95.
[6] 赵慧慧, 洪鸣,钱思轩. 世界卫生组织2016年急性髓系白血病及淋巴细胞白血病/淋巴瘤分类更新解读[J].中国实用内科杂志, 2016,36(8),654-657.
[7] 中国免疫学会血液免疫分会临床流式细胞术学组.多参数流式细胞术检测急性白血病及浆细胞肿瘤微小残留病中国专家共识 (2017年版)[J].中华血液学杂志,2017,38(12): 1001-1011.
[8] GUPTA V,RICHARDS S,ROWE J, et al. Allogeneic, but not autologous, hematopoietic cell transplantation improves survival only among younger adults with acute lymphoblastic leukemia in first remission: an individual patient data meta-analysis[J].Blood,2013, 121(2):339-350.
[9] 徐岳一,杨永公,欧阳建.急性淋巴细胞白血病微小残留病不同监测方法比较[J].白血病?淋巴瘤,2020,10(29):577-580.
[10] 危彤,陈晓娟,张陆阳,等.微小残留病在不同融合基因背景的急性B淋巴细胞白血病患儿中的临床意义[J].中国当代儿科杂志,2020,12(22):1279-1285.
[11] 徐媛媛,高丽,孙君重,等.应用多重巢式RT-PCR初筛急性髓系白血病融合基因及其临床意义[J].中华血液学杂志,2014,35(1):29-34.
[12] PMJ T, DE BIE M, VAN ZESSEN D, et al. Next-generation antigen receptor sequencing of paired diagnosis and relapse samples of B-cell acute lymphoblastic leukemia: clonal evolution and implications for minimal residual disease target selection[J].Leuk Res,2019, 76:98-104.
[13] SHORT N J, JABBOUR E, ALBITAR M, et al. Recommendations for the assessment and management of measurable residual disease in adults with acute lymphoblastic leukemia: a consensus of North American experts[J].Am J Hematol,2019,94(2): 257-265.