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本研究旨在动态监测急性髓系白血病(AML)患者血浆循环DNA的含量,探讨其临床意义。采集66例AML患者不同临床状态的静脉血,以60例体检健康者、20例良性血液病患者、20例实体肿瘤患者为对照,用磁珠法提取血浆标本中循环DNA和内参照质粒DNA,双重荧光定量PCR技术进行DNA定量检测。结果表明:AML患者诊断时血浆DNA含量为168.5(73.4-245.1)ng/ml,显著高于各对照组,男性患者血浆DNA含量显著高于女性患者(P=0.019),不同年龄、不同FAB型别的患者间血浆DNA含量无统计学差异。化疗后血浆DNA水平显著低于化疗前,完全缓解、部分缓解组患者血浆DNA水平与健康对照组已无显著差异,但与未缓解组有显著性差异(P<0.05)。缓解后复发的6例患者中有5例(83.3%)复发时血浆DNA水平明显升高,未复发的25例患者中有22例(88.0%)血浆DNA水平保持稳定。结论:血浆DNA定量检测对AML的化疗疗效判断及复发监测具有重要意义。
The purpose of this study is to dynamically monitor circulating plasma DNA levels in patients with acute myeloid leukemia (AML) and to investigate its clinical significance. Sixty-six patients with AML were enrolled in this study. Sixty healthy controls, 20 benign hematological patients and 20 solid tumors were enrolled in this study. The circulating DNA and internal reference plasmid DNA were extracted by magnetic beads method. Double Fluorescent Quantitative PCR for DNA Quantitative Detection. The results showed that the plasma DNA content of AML patients was 168.5 (73.4-245.1) ng / ml, which was significantly higher than that of the control group. The plasma DNA content of male patients was significantly higher than that of female patients (P = 0.019) Plasma DNA content of other patients was no significant difference. After chemotherapy, the level of plasma DNA was significantly lower than that before chemotherapy, and was completely relieved. There was no significant difference in plasma DNA level between the partial remission group and the healthy control group (P <0.05). Plasma DNA levels were significantly elevated in 5 of 6 (83.3%) patients relapsed after remission, and plasma DNA levels remained stable in 22 (88.0%) of 25 non-relapsed patients. Conclusion: The quantitative detection of plasma DNA is of great significance for the judgment of chemotherapy efficacy and recurrence monitoring of AML.