STR-PCR和FISH在监测异性别异基因造血干细胞移植后嵌合状态中意义的比较

本研究比较短串联重复序列PCR（STR—PCR）和荧光原位杂交（FISH）两种方法在异基因造血干细胞移植后血细胞嵌合状态监测中的意义。对38例接受异性别异基因造血干细胞移植的患者，采用STR—PCR和FISH定量测定移植后14、28天和3个月的骨髓或外周血细胞嵌合状态。结果表明，14天时STR—PCR和FISH同时检测的30例中分别有14例和8例达到完全嵌合（CC，P〉0．05）。28天时两者同时检测的31例中分别有26例和15例达到CC（P〈0．01）。3个月时两种方法共同监测的24例中分别有22例和17例达到CC（P〉0．05）。连续监测3个月以上的28例患者中14倒发生移植物被排斥或复发，其中9例由FISH首先检出（P〈0．05）。结论：FISH检测比STR—PCR更为准确地反映移植早期造血细胞嵌合状态，有助于监测移植物被排斥和疾病复发。

Comparison of STR-PCR and FISH Value for Monitoring Chimerism after Sex-mismatched Allogeneic Hematopoietic Stem Cell Transplantation

This study was purposed to compare the significance of multiplex short tandem repeat polymerase chain reaction （STR-PCR） and fluorescent in situ hybridization （FISH） for monitoring chimerism after sex-mismatched allogeneic hematopoietic stem cell transplantation （allo-HSCT）. The chimerism of bone marrow or peripheral blood cells from 38 patients was analyzed by STR-PCR and FISH on days 14, 28 and at 3 months after alIo-HSCT. The results indicated that on day 14, the complete chimerism （CC） was detected in 14 of 30 cases by STR-PCR and in 8 of 30 cases by FISH （p 〉0.05）. On day 28, the CC was detected in 26 of 31 cases by STR-PCR and in 15 of 31 cases by FISH （p 〈0.01 ）. At 3 months, the CC was observed in 22 of 24 cases by STR-PCR and 17 of 24 cases by FISH （p 〉0.05）. 14 cases were found to have a graft rejection or relapse among 28 cases which were continuously monitored more than 3 months post the transplants. Donor cell decrease in 9 of 14 cases was proved by FISH alone. It is concluded that FISH is more sensitive than STR-PCR in early monitoring chimerism status of post-transplant and in predicting graft rejection or disease relapse.