论著
ENGLISH ABSTRACT
BCR::ABL1 p210转录水平定量检测多中心比对
赵楚婷
倪灿荣
蔺亚妮
马小丽
吴祁生
王芳
韩晓雪
刘丰
徐阳
刘红星
陈杰
汝昆
朱明华
作者及单位信息
·
DOI: 10.3760/cma.j.cn112151-20240110-00024
Comparison of quantitative detection of BCR::ABL1 p210 transcript levels: a multicenter study
Zhao Chuting
Ni Canrong
Lin Yani
Ma Xiaoli
Wu Qisheng
Wang Fang
Han Xiaoxue
Liu Feng
Xu Yang
Liu Hongxing
Chen Jie
Ru Kun
Zhu Minghua
Authors Info & Affiliations
Zhao Chuting
SINO-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-aided Hematopathology Diagnosis, Tianjin 300385, China
Ni Canrong
Department of Pathology, Shanghai Changhai Hospital, Shanghai 200433, China
Lin Yani
SINO-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-aided Hematopathology Diagnosis, Tianjin 300385, China
Ma Xiaoli
Department of Laboratory Medicine, Hebei Yanda Lu Daopei Hospital, Langfang 065200, China
Wu Qisheng
Pathology and Laboratory Medicine Division, Beijing Ludaopei Hospital, Beijing 100176, China
Wang Fang
Kindstar Diagnostics, Wuhan 430075, China
Han Xiaoxue
Tianjin Kingmed Center for Clinical Laboratory, Tianjin 300392, China
Liu Feng
Molecular Diagnostics Laboratory, Beijing GoBroad Boren Hospital, Beijing 100070, China
Xu Yang
Hangzhou Dian Medical Laboratory Center Co Ltd, Hangzhou 310030, China
Liu Hongxing
Department of Laboratory Medicine, Hebei Yanda Lu Daopei Hospital, Langfang 065200, China
Chen Jie
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of medical Sciences, Peking Union Medical College, Beijing 100730, China
Ru Kun
Department of Pathology and Lab Medicine, Shandong Cancer Hospital, Jinan 250117, China
Zhu Minghua
Department of Pathology, Shanghai Changhai Hospital, Shanghai 200433, China
·
DOI: 10.3760/cma.j.cn112151-20240110-00024
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摘要

目的评估7家独立医学实验室BCR::ABL1 p210转录水平定量检测能力及实验室之间结果的可比性。

方法比对分两个阶段完成,由参考实验室制备比对样本,每个阶段比对样本的BCR::ABL1 p210定量值均覆盖0.001%~0.01%、0.01%~0.1%、0.1%~1%、1%~10%及>10%。各比对实验室分别采用即时荧光定量PCR法(real-time quantitative PCR,RT-PCR)和数字PCR法(digital PCR,dPCR)进行比对样本的检测,计算并确认各比对实验室转换因子(conversion factor,CF)。

结果(1)RT-PCR比对中,1家实验室第一阶段14例样本未检出,其余6家实验室比对结果合格,偏倚<±1.2倍(-0.133~0.338),95%一致性界限<±5倍(上限0.147~0.785,下限-0.770~-0.109),计算并确认CF值;(2)dPCR比对中,1家实验室第二阶段未回报结果,其余6家实验室比对结果合格,偏倚<±1.2倍(-0.026~0.267),95%一致性界限<±5倍(上限0.084~0.991,下限-0.669~-0.135),计算并确认CF值;(3)BCR::ABL1 p210定量值为0.01%~0.1%、0.1%~1%、1%~10%及>10%时,RT-PCR和dPCR均能全部检出;BCR::ABL1 p210定量值为0.001%~0.01%时,dPCR检出率高于RT-PCR法(85.56%比68.00%)。

结论各比对实验室结果呈较好一致性,各实验室间BCR::ABL1 p210定量检测通过CF值换算具备可比性;BCR::ABL1 p210深度分子反应定量检测中,dPCR法阳性检出率更高,更有优势;为保证检测结果的准确性和稳定性,各实验室应加强日常质控工作。

白血病,髓系,慢性,BCR-ABL阳性;融合蛋白质类,bcr-abl;实时聚合酶链反应
ABSTRACT

ObjectiveTo assess the capability of seven reference medical laboratories to detect BCR::ABL1 p210 transcription levels and to compare the results among those laboratories.

MethodsThe interlaboratory comparison was carried out in two stages. The samples were prepared by the reference laboratory. The quantitative values of BCR::ABL1 p210 of the comparison samples covered 0.001%-0.01%, 0.01%-0.1%, 0.1%-1%, 1%-10% and>10% in each stage. Real-time quantitative PCR (RT-PCR) and dPCR (digital PCR) were used to examine the samples. The conversion factor (CF) was calculated and validated for each laboratory.

ResultsIn the RT-PCR comparison, one laboratory was failed to detect BCR::ABL1 p210 in fourteen samples at the first stage. The results of the other six laboratories were qualified with the bias <±1.2 folds (-0.133-0.338) and 95% limits of agreement within ±5 folds (upper limit 0.147-0.785, lower limit -0.770--0.109), and the corresponding CF values were calculated and validated. In the dPCR comparison, one laboratory did not report results at the second stage. The results of the other six laboratories were qualified with the bias <±1.2 folds (-0.026-0.267) and 95% limits of agreement within±5 folds (upper limit 0.084-0.991, lower limit -0.669--0.135), and the corresponding CF values were calculated and validated. The samples with BCR::ABL1 p210 quantitative values of 0.01%-0.1%, 0.1%-1%, 1%-10% and >10% could be detected by both RT-PCR and qPCR. When the quantitative value of BCR::ABL1 p210 was 0.001%-0.01%, the detection rate of dPCR was higher than that of RT-PCR (85.56% vs. 68.00%).

ConclusionsA good consistency is present among various laboratories. The quantitative value of BCR::ABL1 p210 is comparable among laboratories as shown by the CF value conversion. For quantitative detection of BCR::ABL1 p210 deep molecular reaction, dPCR has a higher positive detection rate and more advantages than RT-PCR. To ensure the accuracy and reproducibility of the BCR::ABL1 p210 test, it is imperative for every laboratory to enhance their daily quality control practices.

Leukemia, myelogenous, chronic, BCR-ABL positive;Fusion proteins, bcr-abl;Real-time polymerase chain reaction
Zhu Minghua, Email: mocdef.3ab6199246503981

Zhao Chuting and Ni Canrong contributed equally to the article

引用本文

赵楚婷,倪灿荣,蔺亚妮,等. BCR::ABL1 p210转录水平定量检测多中心比对[J]. 中华病理学杂志,2024,53(07):672-677.

DOI:10.3760/cma.j.cn112151-20240110-00024

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*以上评分为匿名评价
慢性髓系白血病(CML)又称慢性粒细胞白血病,是一种起源骨髓造血干细胞,以粒细胞增殖为主的恶性肿瘤 1。BCR::ABL1融合基因是CML特征性的分子改变,诊断CML的最终依据,也是酪氨酸激酶抑制剂(TKI)治疗的分子靶标 2。依据断裂位点的不同,BCR::ABL1可分为BCR::ABL1 p210、BCR::ABL1 p190、BCR::ABL1 p230和其他非典型BCR::ABL1,其中95%以上的CML患者携带BCR::ABL1 p210 3
目前,使用即时荧光定量PCR法(RT-PCR)对BCR::ABL1转录本水平进行定量监测,可准确反映肿瘤负荷,是临床疗效评估的重要指标。如今无治疗缓解(treatment-free remission,TFR)已成为CML治疗的一个新目标。多项研究表明,BCR::ABL1 p210国际标准值(IS)达到≤0.01%(MR4.0)或≤0.0032%(MR4.5)是CML患者TFR的前提条件 4。因此实验室对于BCR::ABL1 p210定量检测,尤其是深度分子反应(BCR::ABL1 p210:MR4.0或MR4.5)检测的能力至关重要。但是目前国内外关于BCR::ABL1 p210的室间比对定量值最低覆盖到0.01%,不能满足临床对于MR4.5甚至更低水平的要求。基于此,中国非公立医疗机构协会病理学专业委员会、国家临床病理质控中心(PQCC)非公组联合组织了BCR::ABL1 p210定量检测的室间比对活动。室间比对活动自2021年11月至2023年2月共分为2个阶段完成,由天津见康华美医学诊断中心作为参考实验室制备样本,共7家独立医学实验室分别采用RT-PCR和数字PCR(digital PCR,dPCR)两种检测方法进行比对,并计算和确认各实验室转换因子(CF),现总结如下。
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备注信息
A
朱明华,Email: mocdef.3ab6199246503981
B

赵楚婷:研究实施、数据采集、数据分析、文章撰写;倪灿荣:研究指导、研究实施、支持性贡献;蔺亚妮:实验酝酿和设计、数据分析、文章审阅、研究指导;马小丽、吴祁生、王芳、韩晓雪、刘丰、徐阳:研究实施;刘红星:研究指导、支持性贡献;陈杰、汝昆、朱明华:酝酿和设计实验、文章审阅、研究指导、支持性贡献

C

赵楚婷和倪灿荣对本文有同等贡献

D
赵楚婷, 倪灿荣, 蔺亚妮, 等. BCR::ABL1 p210转录水平定量检测多中心比对[J]. 中华病理学杂志, 2024, 53(7): 672-677. DOI: 10.3760/cma.j.cn112151-20240110-00024.
E
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