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目的 :探讨儿童ALL(MRD)的相关基因表达及临床意义。方法 :运用PCR技术 ,以IgH和IgRr基因重排为标志 ,检测了 4 8例完全缓解 (CR)的儿童ALL的MRD。结果 :化疗组 (短期 ) 2 8例 ,2 1例阳性 ,阳性检出率为 75.0 %。长期CCR组 2 0例 ,4例阳性 ,阳性检出率为 2 0 .0 %。二组比较采用t检验 ,P <0 .0 5。随访结果 ,化疗组阳性患者中13例复发 ,CCR组阳性患者中 1例复发死亡。结论 :①CR时间越短 ,MRD阳性率越高 ,复发率亦越高。MRD可作为白血病治疗效果及判断预后的一个重要指标。②长期、反复的MRD检测阳性 ,可作为临床停药观察的一个重要指标。③PCR方法准确、先进、方便、适于基层医疗单位推广应用。
Objective: To investigate the gene expression and clinical significance of childhood ALL (MRD). Methods: PCR was used to detect the MRD of 48 children with complete remission (CR) using IgH and IgRr gene rearrangements as markers. Results: Chemotherapy group (short-term) 28 cases, 21 cases were positive, the positive detection rate was 75.0%. Long-term CCR group 20 cases, 4 cases were positive, the positive detection rate of 20.0%. Two groups were compared using t test, P <0. Follow-up results showed that 13 of the patients in the chemotherapy group relapsed, and 1 of the patients in the CCR group relapsed. Conclusion: ① The shorter the time of CR, the higher the positive rate of MRD, the higher the recurrence rate. MRD can be used as a leukemia treatment and prognosis of an important indicator. ② long-term, repeated positive MRD test can be used as an important indicator of clinical withdrawal observed. ③PCR method is accurate, advanced and convenient, suitable for primary medical units to promote the application.