慢性粒细胞白血病患者胸腺输出功能与 bcrabl mRNA水平的关系_临床医学论文.docVIP

慢性粒细胞白血病患者胸腺输出功能与 bcr水平的关系_临床医学论文 慢性粒细胞白血病患者胸腺输出功能与 bcr水平的关系_临床医学论文 【摘要】 本研究了解慢性粒细胞白血病（chronic myelogenous leukemia， CML）患者体内T细胞受体重排删除环（T cell receptor rearrangement excision circles， TREC）的含量与bcr水平的关系，进而明确CML患者的胸腺近期输出功能测定对疾病预后判断的意义。实时定量PCR检测15例CML患者外周血TREC含量及bcr融合基因转录本的水平，并追踪检测6例患者bcr水平的变化。结果发现： 在CML初发时患者外周血TREC含量与bcr融合基因水平无明显的相关性；随访2年后，TREC含量高的患者bcr水平下降幅度更大, 而在接受造血干细胞移植的2例患者中，移植前TREC含量相对较高者，移植1年后连续3次均检测不到bcr，另1例则检测到低水平的bcr。 结论： CML患者胸腺输出功能较高者，可能对机体抵抗残留CML细胞有一定的帮助。 【关键词】 慢性粒细胞白血病 胸腺输出功能 bcr融合基因 TREC Relationship Between Thymus Output Function in CML Patients and Their bcr Abstract The study was purposed to analyze the relationship between the content of Tcell receptor excision DNA circles (TREC) and bcrabl mRNA levels in CML patients and to evaluate the prognostic significance of recent thymic output function detection in patients with chronic myelogenous leukemia (CML). Quantitative detection of TREC and bcrabl fusion gene transcripts in peripheral blood from 15 CML patients were preformed by realtime PCR. The change of bcrabl levels in 6 patients was followedup for two years. The results showed that there was no significant correlation between TREC and bcrabl mRNA levels in peripheral blood from CML patients for the first attack. Patients who had higher TREC at diagnosis had a larger reduction of bcrabl after 2 years of followup. While out of 2 patients who underwent haemopoietic stem cell transplantation(HSCT), one patient with higher level of TREC before transplantation was confirmed to express undetectable level of TREC by three consecutive detections after transplartation, other one patient was identified to express low level of bcrabl. It is concluded that high thymic output function in CML patients can be beneficial for killing the residual CML cells. Key words chronic myelogenous leukemia; thymus output function; bcrabl fusion gene; TREC 肿瘤的发生与机体免疫功能障碍有很大关系，患病机体的免疫状况可影响肿瘤的进展、演化以及预后。胸腺是免疫系统的中枢免疫器官，其功能状态直接决定机体细胞免疫功能,并间接影响体液免疫功能。T细胞受体重排删除环（T ce