中文摘要：

目的利用实时荧光定量RT-PCR方法,检测白血病细胞人类端粒酶反转录酶（hTERT）的表达水平并探讨其临床意义。方法采用基于TaqMan荧光技术的实时定量RT-PCR方法检测白血病患者骨髓单个核细胞及10种白血病细胞系hTERT mRNA拷贝数,来自同种基因移植供者的正常人骨髓细胞作为对照。结果与28例正常人组相比,33例AML1/ETO融合基因阳性的急性髓性白血病（AML）患者骨髓细胞hTERT mRNA水平较高,中位数分别为8.96%（0.23%～76.73%）和4.20%（0.21%～19.90%）（P〈0.01）。47例B-ALL患者骨髓细胞hTERT mRNA水平中位数为20.80%（0.25%～1566.34%）,高于正常人组（P〈0.001）及156例AML组（中位数为2.06%,范围为0～2133.41%）。70例慢性髓性白血病（CML）、36例M3型白血病患者hTERT mRNA水平中位数分别为0.57%（0～14.77%）、0.53%（0～11.10%）,均低于正常人组（P均〈0.001）。15例治疗后达到完全缓解的急性白血病患者与初治时相比,hTERT mRNA水平明显下降,中位数分别为46.53%（8.96%～218.10%）和2.25%（0.18%～45.85%）（P〈0.001）。10种白血病细胞系的hTERT mRNA水平差异甚大。结论 hTERT mRNA在人白血病细胞中的表达水平存在异质性。高表达hTERT mRNA可能是B-ALL及AML1/ETO阳性的AML发病机制中的因素之一。

英文摘要：

Objective To investigate the clinical significance of human telomerase reverse transcriptase （hTERT） messenger RNA expression in the leukemic cells by real-time fluorescent quantitative reverse transcription-polymerase chain reaction （RT-PCR） assay.Methods A real-time quantitative RT-PCR based on TaqMan fluorescence methodology was used to quantify the hTERT mRNA copy numbers in the bone marrow mononuclear cells from patients with leukemia and in ten human leukemic cell lines.Normal marrow samples from the allogeneic stem cell transplantation donors were served as control.Results The expression level of hTERT mRNA was higher in the bone marrow mononuclear cells from 33 FAB（French-American-British,FAB）-M2 patients with AML1/ETO than that from 28 normal donors.The median value was 8.96%（0.23%-76.73%） and 4.20%（0.21%-19.90%）,respectively（P0.01）.The expression levels of hTERT mRNA from 47 B-ALL （median value,20.80%;range,0.25%-1566.34%） elevated significantly comparing with that from 156 AML at initial presention（median value,2.06%;range,0-2133.41%） and normal donors （both P0.001）.But it was lower in the bone marrow mononuclear cells from 70 CML（median value,0.57%;range,0-14.77%） and 36 FAB-M3 patients （median value,0.53%;range,0-11.10%） than that from normal donors （both P0.01）.More over the expression median value from 15 patients with acute leukemia at complete remission reduced significantly than that from these patients at initial presention（46.53%,8.96%-218.10% vs. 2.25%,0.18%-45.85%,P0.001）.The expression levels of hTERT mRNA vary obviously in ten human leukemic cell lines.Conclusions The expression level of hTERT mRNA is of heterogeneity in the leukemic cells.The up-regulation of the expression levels of hTERT mRNA may be one of the factors in the pathogenesis of B-ALL and AML with AML1/ETO.