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目的:应用荧光标记短串联重复序列(STR)复合扩增技术,探讨多个STR基因座在异基因造血干细胞移植后嵌合体状态评估中的作用.方法:对31例移植后患者进行追踪检验,分别PCR复合扩增各病例组常染色体9个STR基因座和Amelogenin基因座,扩增产物经DNA自动分析仪分离后,GeneScan扫描,Genotyper分型.结果:7例患者血由第1次检验结果与供者STR分型一致变为混合型,4例死亡,3例复发;4例患者血由第1次检验结果与供者一致变为受者自身型,均死亡;1例患者血由混合型变为与供者STR分型一致,无复发;1例患者血两次检验均为混合型,已死亡;其余18例患者血均与供者血STR分型一致,其中16例目前预后较好,2例已死亡.结论:复合扩增STR基因座具有较高的个体识别力,检测灵敏、准确、快速,在对异基因造血干细胞移植患者的植入情况进行动态检测的研究中有用,对移植物植入或被排斥、疾病复发均有预警作用,同时必须结合临床症状,及时地进行STR检测,以便于早期实施临床干预治疗.
OBJECTIVE: To investigate the role of multiple STR loci in the evaluation of chimera status after allogeneic hematopoietic stem cell transplantation by fluorescence-labeled short tandem repeat (STR) multiplex amplification.Methods: 31 cases of posttransplantation patients were followed up, 9 STR loci and Amelogenin loci of autosomal chromosomes were amplified by PCR, and the amplified products were separated by DNA automated analyzer, then genotyped by GeneScan and Genotyper.Results: The results of the first test 4 patients died, 3 patients relapsed; 4 patients with blood from the first test results consistent with the donor into the recipient type, all died; one patient with blood from the mixed Type into the same with the donor STR typing, no recurrence; one patient two tests were mixed blood, has died; the remaining 18 patients with blood donor STR typing are consistent, of which 16 cases of the current prognosis than 2 cases were dead.Conclusion: The STR loci amplified by multiplex amplification have high individual identification ability, which is sensitive, accurate and rapid, and is useful in the dynamic study of the implantation of allogeneic hematopoietic stem cell transplantation patients. Implantation or rejection of the graft, the disease complex Are warning effect, and must be combined with clinical symptoms, STR detected timely manner, in order to implement the early clinical intervention.