| ObjectiveIn this study,the multiple nested RT-PCR technique was applied to explore the general situation of acute lymphoblastic leukemia(ALL)in children at the initial diagnosis.It was also applied to deal with the difference in the fusion gene type and occurrence frequency.Through this kind of technique method,we can make clinical accurate classification and reasonable treatment plan.MethodsChildren with acute lymphoblastic leukemia were collected from the Third Affiliated Hospital of Zhengzhou University and the First Affiliated Hospital of Zhengzhou University from December 2015 to November 2018.A total of 248 cases were collected and tested.MICM tests were performed on all the children with leukemia.General data and early detection data were retrospectively analyzed,and relevant statistical results were compared with large sample data which was reported internationally.Among them,15 common fusion genes in ALL were detected by multiple nested RT-PCR.Results(1)All specimens were tested by Immunotyping detection.The ratio of male to female was 1.38:1.There was no significant difference in the sex distribution of children in different age groups(P>0.05).There were significant differences in pro-B-ALL,pre-B-ALL,common B-ALL and mature B-ALL among different age groups(P<0.05).(2)98 leukemia genes were detected in 248 children(39.52%)and 22(8.87%)of BCR/ABL1 positive,26(10.48%)cases of ETV6/RUNX1 positive,19 cases of E2A/PBX1 positive(7.66%),18 cases of MLL positive(7.25%)and 8 cases of SIL/TAL1 positive(3.23%)were detected.The proportion of fusion genes and immune subtypes was compared,and the difference was statistically significant(P<0.05).(3)There was a significant difference between the proportion of fusion genes and immune subtypes.The positive incidence of leukemia fusion gene was different in all age groups.The incidence of MLL gene positive was the highest in the <1 year group(20.00%),ETV6/RUNX1 gene positive rate was the highest in the 1-10 year group(14.29%)and BCR/ABL1 gene positive rate was the highest in the >10 year group(16.92%).(4)Among the children with positive fusion gene changes,there were 220 cases of B-ALL and 28 cases of T-ALL in ETV6/RUNX1 gene,BCR/ABL1 gene are common in B-ALL,MLL gene is common in pro-B-All,and SIL/TAL1 gene is common in T-ALL.(5)Among 248 cases,77 showed abnormal karyotypes.The other 36 cases were abnormal chromosome structure.Changes related to BCR/ABL1,E2A/PBX1 and MLL genes were detected,but no changes related to ETV6/RUNX1 fusion genes were detected.(6)The WBC and PLT counts in the blood routine at the first diagnosis were statistically significant in the distribution of each age group.Among them,WBC counts was higher in the < 1 year old group(P<0.05),and PLT counts was lower in the > 10 year old group(P<0.05).The Hb counts in blood routine at the first diagnosis showed no statistical significance in the distribution of each age group(P>0.05).Conclusions(1)Incidence of fusion genes in ALL children : BCR/ABL1 positive 8.87%,ETV6/RUNX1 positive 8.87%,E2A/PBX1 positive 7.66%,MLL positive 7.25% and SIL/TAL1 positive 3.23%.(2)This group of data shows that the common fusion gene types of ALL in children of different ages are basically consistent with the literature reports,but the positive rate of some fusion genes detected is different from the literature reports,which may be related to the region and ethnicity. |
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