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1、·24·解放軍醫(yī)學(xué)雜志2010年1月1日第35卷第1期MedJChinPLA,Vol135,No11,January1,2010白血病患者循環(huán)DNA定量和完整性分析及其臨床意義高玉潔,楊再林,鐘曉明,邵會(huì)媛,楊松,肖玲,白垚,蔡曉鐘,張伶[摘要]目的分析白血病患者血漿DNA的含量及完整性,并探討其臨床意義。方法以2008年6月-2009年3月收治的60例白血病患者作為實(shí)驗(yàn)組,同期在門診行體檢的健康正常人20例、血液系統(tǒng)良性病變者20例、淋巴瘤患者10例、實(shí)體腫瘤患者20例(食管癌6例、原發(fā)性肝癌4例、鼻咽癌5例、乳腺癌5例)作為對(duì)照組(n=70)。測(cè)定兩組患者的血漿DNA含量,比較兩組
2、間、不同F(xiàn)AB分型的急性髓細(xì)胞白血病患者間、實(shí)驗(yàn)組不同年齡段及不同病程患者間血漿DNA水平的差異。采用聚合酶鏈反應(yīng)擴(kuò)增β2actin大片段和小片段產(chǎn)物并行瓊脂糖凝膠電泳觀察,比較實(shí)驗(yàn)組患者與對(duì)照組中正常人血漿DNA的差異。結(jié)果實(shí)驗(yàn)組患者血漿DNA濃度(41312±11814μg/L)約為對(duì)照組中正常人(1916±719μg/L)的21倍(P<0105),且高于對(duì)照組的其他疾病患者(P<0105)。實(shí)驗(yàn)組血漿DNA濃度與年齡及疾病病程有關(guān),不同F(xiàn)AB型別的急性髓細(xì)胞白血病患者血漿DNA含量無(wú)顯著差異。實(shí)驗(yàn)組血漿DNA電泳呈現(xiàn)大小不一的片段,而且其血漿DNA中可擴(kuò)增出β2actin的大、小
3、片段產(chǎn)物,完整性較高。正常人僅可見(jiàn)少量小片段DNA。結(jié)論白血病患者血漿DNA含量和完整性明顯增高,對(duì)白血病的診斷及預(yù)后判斷具有重要價(jià)值。[關(guān)鍵詞]白血病;DNA;血漿[中圖分類號(hào)]R73317;R446111[文獻(xiàn)標(biāo)志碼]A[文章編號(hào)]057727402(2010)0120024204Quantification,integrityevaluationandclinicalsignificanceofcirculatingDNAinplasmaofleukemiapatientsGAOYu2jie,YANGZai2lin,ZHONGXiao2ming,SHAOHu2yuan,YANGS
4、ong,XIAOLing,BAIYao,CAI3Xiao2zhong,ZHANGLing1DepartmentofClinicalHematology,FacultyofLaboratoryMedicine,ChongqingUniversityofMedicalSciences,Chongqing400016,China3Correspondingauthor,E2mail:cqumszhl@sina.com[Abstract]ObjectiveToevaluatetheclinicalsignificanceofdetectionofbothplasmaDNAconcentrati
5、onandintegrityinleukemiapatients.MethodsSixtyleukemiapatientswereassignedasexperimentalgroup,andthecontrolgroupconsistedof70subjects,including20healthysubjectsforhealthcheckinout2patientclinic,20patientswithbenignhematologicaldiseases,10casesoflymphomaand20casesofsolidtumors(6casesofesophagealca
6、rcinoma,4casesofprimaryhepaticcarcinoma,5casesofnasopharyngealcarcinomaand5casesofbreastcancer).PlasmaDNAofpatientsinthebothgroupsweredetected,andthedifferencesinplasmaDNAlevelwerethencomparedrespectivelybetweenthepatientswithdifferentFABtypesofacutemyelocyteleukemia(AML)andthoseinexperimentalgr
7、oupwithvariousageorclinicalscenarios.Polymerasechainreaction(PCR)wasperformedtoamplifylargeandshortfragmentsofβ2actin,andintegrityofplasmaDNAwasanalyzedwithagarosegelelectrophoresis.ResultsMeanconcentrationofplasmaDNAinexper
