摘要目的为了研究骨髓增生异常综合征的骨髓单个核细胞中端粒酶的表达特点,并与正常骨髓、急性白血病进行比较.方法我们用PCR-ELISA法对20例正常骨髓、21例骨髓增生异常综合征32例急性白血病骨髓单个核细胞的端粒酶活性进行半定量检测.结果发现正常骨髓细胞端粒酶表达范围0～0.30U,平均0.11±0.08U,其中仅有3例阳性.急性白血病骨髓细胞端粒酶表达范围0～0.96U,平均0.42±0.26U,阳性率78.1%,与正常骨髓相比,有显著性差异(P<0.01).MDS端粒酶表达范围0～0.97U,平均为0.27± 0.19U,阳性率为66.7%.与正常相比,端粒酶表达均值之间的差别有显著性(P<0.0 5).其中高风险组端粒酶表达较高(P<0.05).IPPS评分等级为INT-1,2与HIGH组的MDS骨髓细胞端粒酶活性水平之间差异有显著性(P<0.05).端粒酶活性与染色体异常程度无明显关系.结论结果提示正常骨髓细胞具有临界水平的端粒酶活性,急性白血病端粒酶活性显著升高,而MD S则介于正常与急性白血病之间.其中高风险组、IPPS评分预后差的MDS端粒酶活性较高.

abstractsObjective To study telomerase activity (TA) and its variation in bone marrow mononuclear cells from patients with myelodysplastic syndrome (MDS) at different stages in comparison with normal bone marrow cells and leukemic cells. Methods The TA was semi-quantitatively determined in mononuclear cells from 20 normal bone marrow samples, 21 patients with MDS at different stages and 32 cases of acute leukemia by using a polymerase chain reaction-enzyme linked immuno-sorben assay (PCR-ELISA) kit. Results The TA in normal bone marrow cells was in the range of 0 to 0.3 units (U) with a mean of 0.11±0.08 U. Among them, 3 samples were considered positive in accordance with the standard recommended by the kit's pamphlet. In bone marrow cells from patients with acute leukemia, the TA was ranging from 0 to 0.96 U with a mean value of 0.42±0.26 U. The positive rate was 78.1% which was signific antly different from that in normal bone marrow (BM) (P<0.01). In case of myelodysplastic syndrome, the average level of TA was 0.27±0.19 U (ranging fr om 0 to 0.97 U) with a positive rate of 66.7%. In comparison with normal BM cells, the difference was significant (P<0.05). Particularly, the MDS high -risk subgroup exhibited a significantly higher activity of telomerase (P<0 .05). In comparison with INT-1 and INT-2 subgroups in MDS patients based on international prognostic scoring system (IPPS), the difference in TA was also si gnificant (P<0.05). The abnormality in cell karyotype was not correlated w ith TA.Conclusion The normal bone marrow cells demonstrate TA at a marginal level while a remarkab ly increasing level may be seen in acute leukemia patients. The BM cells from M DS patients display a moderate TA among which the high risk MDS subgroup with a poor prognostic IPPS score exhibited markedly higher TA.