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采用不同分子诊断技术对JAK2V617F突变进行评估的比较。

Comparison of JAK2V617F mutation assessment employing different molecular diagnostic techniques.

作者信息

Veneri Dino, Capuzzo Enrico, de Matteis Giovanna, Franchini Massimo, Baritono Elisabetta, Benati Marco, Solero G Pietro, Ambrosetti Achille, Quaresmini Giulia, Pizzolo Giovanni

机构信息

Dipartimento di Medicina Sperimentale e Clinica, Sezione di Ematologia, Università di Verona, Verona, Italy.

出版信息

Blood Transfus. 2009 Jul;7(3):204-9. doi: 10.2450/2009.0070-08.

Abstract

BACKGROUND

The JAK2(V617F) mutation is present in the majority of patients with polycythaemia vera and in approximately half of patients with essential thrombocythaemia and primary myelofibrosis. In this study we compare the results of JAK2(V617F) mutation detection using three different molecular techniques in the same group of patients affected by essential thrombocythaemia.

PATIENTS AND METHODS

The JAK2 mutation was investigated with a qualitative method in 115 consecutive outpatients with a diagnosis of essential thrombocythaemia made according to WHO 2001 criteria. In 48/115 (41.7%) the allele burden was also evaluated with two different qualitative methods, of which one was a method developed in-house and the other was a commercially available method.

RESULTS

The JAK2(V617F) mutation was detected by the qualitative method in 81/115 (69.6%) of the patients. Among the 48/115 patients in whom all three methods were applied, the qualitative method detected the mutation in 38 (79%). According to the quantitative method developed in-house, the mutation was present in 35/48 (73%) of the patients: of these, 2/35 (5.7%) patients were homozygous for the JAK2(V617F) mutation. The commercial quantitative method showed the mutation in 37/48 (77%) patients: of these, 9/37 (18%) patients were homozygous. Three of the 13 patients in whom no mutation was detected by the in-house method were positive for the JAK2(V617F) according to the commercial method. In one patient the search for the JAK2(V617F) mutation was positive with the in-house method but negative with the commercial kit.

CONCLUSION

Detection of the JAK2(V617F) mutation may depend on the molecular technique used. Considering that detection of this mutation will not only have a diagnostic value, but also a role in treatment given the development of JAK2(V617F) pathway inhibiting drugs, indications on a reference molecular diagnostic technique for JAK2(V617F) assessment and quantification of its allele burden from a panel of experts are warranted.

摘要

背景

大多数真性红细胞增多症患者以及约一半的原发性血小板增多症和原发性骨髓纤维化患者存在JAK2(V617F)突变。在本研究中,我们比较了在同一组原发性血小板增多症患者中使用三种不同分子技术检测JAK2(V617F)突变的结果。

患者与方法

采用定性方法对115例根据WHO 2001标准诊断为原发性血小板增多症的连续门诊患者进行JAK2突变检测。在48/115(41.7%)的患者中,还使用两种不同的定性方法评估了等位基因负荷,其中一种是内部开发的方法,另一种是市售方法。

结果

通过定性方法在81/115(69.6%)的患者中检测到JAK2(V617F)突变。在应用了所有三种方法的48/115例患者中,定性方法在38例(79%)患者中检测到突变。根据内部开发的定量方法,35/48(73%)的患者存在该突变:其中,2/35(5.7%)的患者为JAK2(V617F)突变纯合子。市售定量方法显示37/48(77%)的患者存在该突变:其中,9/37(18%)的患者为纯合子。在内部方法未检测到突变的13例患者中,有3例根据市售方法JAK2(V617F)呈阳性。在1例患者中,内部方法检测JAK2(V617F)突变呈阳性,但市售试剂盒检测呈阴性。

结论

JAK2(V617F)突变的检测可能取决于所使用的分子技术。鉴于该突变的检测不仅具有诊断价值,而且鉴于JAK2(V617F)通路抑制药物的开发在治疗中也具有作用,因此有必要由一组专家就用于JAK2(V617F)评估及其等位基因负荷定量的参考分子诊断技术给出指示。

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