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骨髓增殖性疾病患者的JAK2V617F突变及其与临床特征的关系

[JAK2V617F mutation in the patients with myeloproliferative disorder and its relation with clinical characteristics].

作者信息

Zhu Jun-Fang, Liu Yuan, Liu Pei, Jia Ming-Feng, Cheng Juan, Zhao Li

机构信息

Lanzhou University First Hospital, Lanzhou, Gansu Province, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2011 Aug;19(4):916-20.

Abstract

This study was aimed to investigate the incidence of JAK2V617F mutation in BCR-ABL negative patients with myeloproliferative disorders (MPD) and its relation with clinical characteristics of MPD. The sensitive and specific test for JAK2V617F mutation was established for improving diagnosis level in Gansu province. 47 BCR/ABL negative MPD patients and 12 healthy people were enrolled in this study. Allele specific polymerase chain reaction (AS-PCR) was used to amplify the exon 12 of JAK2 gene which harbours V617F mutation. The PCR products were identified by DNA sequencing. And its relation with clinical characteristics of MPD was analyzed also. The results indicated that the incidence of JAK2V617F positive mutation in 47 patients with BCR-ABL negative MPD was 74.5 % (35/47), including 83.9 %(26/31) in patients with polycythemia vera (PV), 60 % (9/15) in patients with essential thrombocythemia (ET), only in one patient with idiopathic myelofibrosis (IMF). In PV group, the patients with JAK2V617F positive mutation had higher counts of WBC and Plt than patients with JAK2V617F negative mutation. In ET group, the patients with JAK2V617F positive mutation had higher WBC count and Hb level than those in the patients with JAK2V617F negative mutation with tendency of suffering from complications such as hepatosplenomegaly, haemorrhage and thrombosis. It is concluded that JAK2V617F mutation is more frequent in BCR-ABL negative patients with MPD, the AS-PCR method is sensitive and specific for detection of the mutation and may successfully use in clinical examination.

摘要

本研究旨在探讨BCR-ABL阴性骨髓增殖性疾病(MPD)患者中JAK2V617F突变的发生率及其与MPD临床特征的关系。为提高甘肃省的诊断水平,建立了JAK2V617F突变的灵敏特异检测方法。本研究纳入了47例BCR/ABL阴性MPD患者和12名健康人。采用等位基因特异性聚合酶链反应(AS-PCR)扩增携带V617F突变的JAK2基因第12外显子。通过DNA测序鉴定PCR产物。并分析其与MPD临床特征的关系。结果表明,47例BCR-ABL阴性MPD患者中JAK2V617F阳性突变的发生率为74.5%(35/47),其中真性红细胞增多症(PV)患者中为83.9%(26/31),原发性血小板增多症(ET)患者中为60%(9/15),仅1例原发性骨髓纤维化(IMF)患者有该突变。在PV组中,JAK2V617F阳性突变患者的白细胞和血小板计数高于JAK2V617F阴性突变患者。在ET组中,JAK2V617F阳性突变患者的白细胞计数和血红蛋白水平高于JAK2V617F阴性突变患者,且有肝脾肿大、出血和血栓形成等并发症的倾向。结论:JAK2V617F突变在BCR-ABL阴性MPD患者中较为常见,AS-PCR方法检测该突变灵敏特异,可成功应用于临床检测。

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