恶性血液病细胞端粒酶活性检测及其临床意义

目的　研究恶性血液病的端粒酶活性表达情况,探讨端粒酶活性检测对恶性血液病的临床意义。方 法　选取各类恶性血液病病例87例,以良性血液病和骨髓形态学正常的非血液病患者作为对照,采用改良 TRAP 银染法及亚利恩凝胶成像系统检测其骨髓标本内的端粒酶活性水平并随访。结果　良性血液病时端粒 酶阴性或低水平表达;慢性白血病慢性期、骨髓增生异常综合征(MDS)、多发性骨髓瘤(MM)骨髓端粒酶活性轻 度或中度升高,急性白血病和慢性白血病急变期端粒酶活性显著升高,完全缓解后活性水平下降,复发时端粒酶 活性又升高。同时端粒酶活性水平与预后相关,活性高者往往预后较差。结论　端粒酶活化与肿瘤的恶性转化 密切相关,可作为恶性血液病恶性克隆增殖的分子标志,有希望成为监测微量残留白血病的一个新指标。

Activity and clinical significance of telomerase in malignant hemopathy

Objective To study the expression level of telomerase activity and explore its clinical significance in malignant hemopathy. Methods A total of 87 patients with various malignant hematologic disorders were analyzed by modified TRAP-silver staining assay and Yalien analyzing software.Benign hemopathic patients and non-hemopathic patients with normal bone marrow figures were studied as controls simultaneously. Results Telomerase expression was negative or of low level in benign hemopathy.Telomerase activity increased slightly or moderately in the chronic leukemia(chronic phase),myelodysplastic syndrome and multiple myeloma patients.In acute leukemia and chronic myeloid leukemia(blastic phase),telomerase activity increased significantly,then decreased after complete remission and also increased on relapse.High telomerase activity was assosiated with poor prognosis. Conclusions Telomerase activity could be a useful marker for evaluating malignant clonal proliferation,and it is hopeful to become a new molecular target for monitoring minimal residual leukemia.