实时定量PCR法检测淋巴瘤患者Bcl-2／IgH融合基因及其临床意义

本研究目的是检测滤泡性淋巴瘤和弥漫大B细胞淋巴瘤患者bcl-2／IgH融合基因的表达水平，以探讨其临床意义。以SYBRGreenI荧光染料实时定量PCR方法检测20例患者外周血和（或）骨髓bcl-2／IgH融合基因的表达水平，并对其中4例患者bcl。2／IgH融合基因的表达水平进行动态监测。结果表明，在bcl-2／IgH融合基因阳性表达的病例中，骨髓和外周血bcl-2／IgH融合基因的相对拷贝数分别为4．23和2．73，统计学分析差异无显著性（P=0．107），而治疗前后融合基因的相对拷贝数均数分别为3．61和2．69，统计学分析差异有显著性（P=0．000），初诊及复发组的bcl-2／IgH融合基因表达水平明显高于缓解组（P=0．008），在4例患者的外周血bcl-2／IgH融合基因动态监测结果中，l例患者在临床复发前3个月bcl-2／IgH融合基因表达水平明显上升。结论：bcl-2／IgH融合基因表达水平与患者的疾病状态有一定的相关性，初诊及复发患者融合基因的表达水平高，而缓解患者融合基因的表达水平低，治疗后融合基因表达水平较治疗前明显下降，bcl／IgH融合基因表达水平的变化可能与临床疾病进程有关，检测外周血是比较可行的。

Detection of Bcl-2/IgH Fusion Gene in Lymphoma by Real-Time Polymerase Chain Reaction and Its Clinical Significance

The aim of this study was to investigate the bcl-2/IgH expression levels in patients with follicular lymphoma （FL） and diffuse large B-cell lymphoma （DLBCL） and its clinical significance. The bcl-2/IgH expression levels in bone marrow （BM） and/or peripheral blood （PB） of 20 patients were detected by using SYBR Green I real-time polymerase chain reaction, and the dynamic monitoring for bcl-2/IgH expression level in 4 of these patients was performed. The results showed that in patinets with bcl-2/IgH-positive there was no statistically significant difference in the relative copy-numbers of bcl-2/IgH fusion gene in BM and PB （4.23 and 2.73 respectively, p = 0. 107 ）, but the diff- erence was significant before and after treatment （3.61 and 2.69 respectively, p = 0.000）, the expression level of bcl-2/ IgH fusion gene in newly diagnosed and relapsed group was remarkably higher than that in remission group （p = 0. 008 ）. The bcl-2/IgH expression level in PB increased evidently 3 months prior to the clinical relapse in one case out of dynamicalty monitored 4 cases. It is concluded that the bcl-2/IgH expression level is associated with the disease status, the expression level is high in newly diagnosed and relapsed patients and low in those who achieved remission, the bcl-2/IgH fusion gene expression level decreased evidently after therapy, this change may be related to the clinical disease progression, the results suggest that peripheral blood can be regarded as the resource for detection of bcl-2/IgH fusion gene.