\u6587\u7ae0 | \u57fa\u56e0\u6167\u7f16\u8f91 | Kathy\u00a0\u5ba1\u6838 | Mary<\/div>\n
\u5173\u952e\u8bcd | \u8840\u6db2\u80bf\u7624\uff1bMRD\uff1bMGS<\/div>\n
\u00a0<\/div>\n
\u8840\u6db2\u80bf\u7624\u53d1\u75c5\u7387\u548c\u6b7b\u4ea1\u7387\u9010\u5e74\u589e\u9ad8<\/div>\n
\u76ee\u524d\uff0c\u4e2d\u56fd\u8840\u6db2\u80bf\u7624\u7684\u53d1\u75c5\u7387\u548c\u6b7b\u4ea1\u7387\u6709\u9010\u5e74\u589e\u9ad8\u7684\u8d8b\u52bf\u3002\u4ee5\u6dcb\u5df4\u7624\u548c\u9aa8\u9ad3\u7624\u4e3a\u4f8b\uff0c\u636e\u4f30\u8ba1\uff0c2017\u5e74\u4e2d\u56fd\u4e0e\u6dcb\u5df4\u7624\u548c\u9aa8\u9ad3\u7624\u76f8\u5173\u7684\u6b7b\u4ea1\u6848\u4f8b\u8fbe\u5230 52,000 \u4f8b\uff0c\u6b7b\u4ea1\u7387\u7ea6\u4e3a3.83\/10\u4e07\u3002\u4e2d\u56fd\u5e74\u9f84\u6807\u5316\u6b7b\u4ea1\u7387(ASMRC)\u4e3a3.74\/10\u4e07\uff0c\u5168\u7403\u5e74\u9f84\u6807\u51c6\u5316\u6b7b\u4ea1\u7387(ASMRW)\u4e3a2.60\/10\u4e07[1]\u3002<\/div>\n
\u88681 2017\u5e74\u4e2d\u56fd\u6dcb\u5df4\u7624\u548c\u9aa8\u9ad3\u7624\u6b7b\u4ea1\u7387[1]<\/div>\n\n
\n![\"RmFicvQBAkgCmDz3SgnnYiaJz7DE6EqzU4VvBJLCFZOibIELmZFsBodR9zYGmBwXib0fkq38hwdDXnw7jSqKE1icn5w\"\/](\"https:\/\/www.geneclub.net.cn\/wp-content\/uploads\/images\/RmFicvQBAkgCmDz3SgnnYiaJz7DE6EqzU4VvBJLCFZOibIELmZFsBodR9zYGmBwXib0fkq38hwdDXnw7jSqKE1icn5w.png\")
<\/figure><\/div>\n\n
<\/figure><\/div>\n\n\u88682 2004-2016\u5e74\u4e2d\u56fd\u6dcb\u5df4\u7624\u548c\u9aa8\u9ad3\u7624\u6b7b\u4ea1\u7387\uff08\u6309\u4e2d\u56fd\u6807\u51c6\u4eba\u7fa4\u5e74\u9f84\u6807\u5316\uff09\u8d8b\u52bf[1]<\/div>\n\n
\n![\"RmFicvQBAkgCmDz3SgnnYiaJz7DE6EqzU4kG2cukVEiaJGHkialrLowxJNYBeBkwQATBwIV6TT8rjZsCaibRv0Xv4rA\"\/](\"https:\/\/www.geneclub.net.cn\/wp-content\/uploads\/images\/RmFicvQBAkgCmDz3SgnnYiaJz7DE6EqzU4kG2cukVEiaJGHkialrLowxJNYBeBkwQATBwIV6TT8rjZsCaibRv0Xv4rA.png\")
<\/figure><\/div>\n\n
<\/figure><\/div>\n\n\u636e\u4f30\u7b97\uff0c2016\u5e74\u4e2d\u56fd\u591a\u53d1\u6027\u9aa8\u9ad3\u7624\u65b0\u53d1\u6848\u4f8b\u4e3a16500\u4f8b\uff0c\u6b7b\u4ea1\u60a3\u8005\u8fbe\u523010300\u4f8b\u3002\u9aa8\u9ad3\u7624\u5e74\u9f84\u6807\u5316\u53d1\u75c5\u7387\uff08ASIR\uff09\u4e3a1.03\/10\u4e07 (95% UI, 0.88\uff5e1.17)\uff0c\u5e74\u9f84\u6807\u5316\u6b7b\u4ea1\u7387\uff08ASMR\uff09\u4e3a0.67\/10\u4e07 (95% UI, 0.59\uff5e0.77)[2]\u3002<\/div>\n
\u00a0<\/div>\n
\u88683 2016\u5e74\u4e2d\u56fd\u591a\u53d1\u6027\u9aa8\u9ad3\u7624\u53d1\u75c5\u7387\u53ca\u6b7b\u4ea1\u7387\uff08\u6309\u5e74\u9f84\u548c\u6027\u522b\u5212\u5206\uff09[2]<\/div>\n\n
\n![\"RmFicvQBAkgCmDz3SgnnYiaJz7DE6EqzU4NtRcURxxMfmTdkkyknR3kOWKwSicuNdfnibZlTbphZvU1erHtYwDMf4Q\"\/](\"https:\/\/www.geneclub.net.cn\/wp-content\/uploads\/images\/RmFicvQBAkgCmDz3SgnnYiaJz7DE6EqzU4NtRcURxxMfmTdkkyknR3kOWKwSicuNdfnibZlTbphZvU1erHtYwDMf4Q.png\")
<\/figure><\/div>\n\n
<\/figure><\/div>\n\n\u56e0\u6b64\uff0c\u5728\u4e34\u5e8a\u4e0a\u5c06\u65b0\u6280\u672f\u5e94\u7528\u5728\u8840\u6db2\u80bf\u7624\u7684\u9884\u9632\u3001\u8bca\u65ad\u3001\u6cbb\u7597\u3001\u9884\u540e\u53ca\u590d\u53d1\u76d1\u6d4b\u7b49\u5168\u8fc7\u7a0b\uff0c\u8ba9\u60a3\u8005\u83b7\u5f97\u66f4\u597d\u7684\u6cbb\u7597\uff0c\u8fbe\u5230\u957f\u671f\u751f\u5b58\uff0c\u751a\u81f3\u4e34\u5e8a\u6cbb\u6108\uff0c\u5df2\u523b\u4e0d\u5bb9\u7f13\u3002<\/div>\n
\u00a0<\/div>\n
\u8840\u6db2\u80bf\u7624\u4e2d\u7684MRD\u68c0\u6d4b\u6280\u672f<\/div>\n
MRD\u662f\u6307\u5fae\u5c0f\u6b8b\u7559\u75c5\u7076\uff08Minimal Residual Disease\uff0cMRD\uff09\uff0c\u764c\u75c7\u60a3\u8005\u7ecf\u6cbb\u7597\u540e\uff0c\u6709\u6781\u5c11\u6570\u5bf9\u6cbb\u7597\u65e0\u53cd\u5e94\u6216\u8010\u836f\u7684\u764c\u7ec6\u80de\u4f1a\u6b8b\u7559\u5728\u4f53\u5185\u3002\u56e0\u6570\u91cf\u5f88\u5c11\uff0c\u8fd9\u4e9b\u764c\u7ec6\u80de\u4e0d\u4f1a\u5f15\u8d77\u8eab\u4f53\u4efb\u4f55\u590d\u53d1\u75c7\u72b6\u548c\u8868\u73b0\uff0c\u6240\u4ee5\u5f88\u96be\u901a\u8fc7\u663e\u5fae\u955c\u89c2\u5bdf\u6216\u8ffd\u8e2a\u80bf\u7624\u6807\u5fd7\u7269\u7b49\u4f20\u7edf\u4e34\u5e8a\u65b9\u6cd5\u68c0\u6d4b\u51fa\u8fd9\u4e9b\u764c\u7ec6\u80de\uff0c\u4f46\u5b83\u4eec\u5f88\u6709\u53ef\u80fd\u5bfc\u81f4\u764c\u75c7\u590d\u53d1\uff0c\u4ece\u800c\u5f71\u54cd\u60a3\u8005\u7684\u751f\u5b58\u7387\u53ca\u751f\u6d3b\u8d28\u91cf\u3002<\/div>\n
\u00a0<\/div>\n
\u56e0\u6b64\uff0c\u76d1\u6d4b\u764c\u75c7\u60a3\u8005\u5728\u764c\u75c7\u8bca\u7597\u5168\u8fc7\u7a0b\u4ee5\u53ca\u4e34\u5e8a\u7f13\u89e3\u540e\u4e0d\u540c\u65f6\u95f4\u70b9\u7684MRD\u6c34\u5e73\u662f\u975e\u5e38\u91cd\u8981\u7684\u3002\u533b\u751f\u53ef\u4ee5\u6839\u636eMRD\u7684\u52a8\u6001\u53d8\u5316\u5bf9\u60a3\u8005\u8fdb\u884c\u5177\u4f53\u7684\u7597\u6548\u8bc4\u4f30\u3001\u6cbb\u7597\u6307\u5bfc\u53ca\u590d\u53d1\u9884\u6d4b\u3002\u6839\u636e\u60a3\u8005\u7684\u5177\u4f53\u60c5\u51b5\uff0c\u68c0\u6d4bMRD\u7684\u65f6\u95f4\u70b9\u548c\u68c0\u6d4b\u6b21\u6570\u4e5f\u5404\u4e0d\u76f8\u540c\u3002\u76ee\u524d\uff0cMRD\u68c0\u6d4b\u7684\u4e34\u5e8a\u5e94\u7528\u5df2\u5199\u5165\u591a\u79cd\u5171\u8bc6\u53ca\u6307\u5357\u3002\u6709\u5c0f\u513f\u8840\u6db2\u75c5\u4e34\u5e8a\u4e13\u5bb6\u8868\u793a\uff0c\u5728\u5176\u4e13\u6ce8\u7684\u9886\u57df\u4e2d\uff0c\u56fd\u9645\u4e0a\u7684\u57fa\u672c\u8981\u6c42\u662f\u5728\u7597\u7a0b\u7684\u7b2c15\u5929\/19\u5929\u3001\u7b2c33\u5929\/46\u5929\uff0c\u4ee5\u53ca\u7b2c78\u5929\u65f6\u8fdb\u884cMRD\u68c0\u6d4b\u3002<\/div>\n
\u00a0<\/div>\n
\u5e38\u89c1\u7684MRD\u68c0\u6d4b\u6280\u672f<\/div>\n
\u76ee\u524d\uff0cMRD\u6280\u672f\u5728\u8840\u6db2\u80bf\u7624\u4e2d\u5e94\u7528\u8f83\u5e7f\uff0c\u5728\u5b9e\u4f53\u80bf\u7624\u4e2d\u7684\u5e94\u7528\u8fd8\u5904\u4e8e\u521d\u671f\u9636\u6bb5\u3002\u5e38\u89c1\u7684MRD\u68c0\u6d4b\u6280\u672f\u5305\u62ec\u6d41\u5f0f\u7ec6\u80de\u672f\u3001PCR\u6cd5\u548cNGS\u3002\u6d41\u5f0f\u7ec6\u80de\u672f\u662fMRD\u68c0\u6d4b\u7684\u7ecf\u5178\u6280\u672f\uff0c\u7cbe\u786e\u5ea6\u4e00\u822c\u572810\u7684\u8d1f\u56db\u6b21\u65b9\u81f310\u7684\u8d1f\u4e94\u6b21\u65b9\u6c34\u5e73\u3002PCR\u6cd5\u4e5f\u5df2\u7ecf\u5728\u4e34\u5e8a\u4e0a\u5e7f\u6cdb\u5e94\u7528\uff0c\u4f46\u4e8c\u8005\u90fd\u5b58\u5728\u7740\u7075\u654f\u5ea6\u4f4e\u3001\u7279\u5f02\u6027\u5dee\u7b49\u7279\u70b9\uff0c\u65e0\u6cd5\u5bf9\u75be\u75c5\u8d1f\u8377\u8fdb\u884c\u51c6\u786e\u5b9a\u91cf\uff0c\u4e5f\u4e0d\u80fd\u6df1\u5ea6\u68c0\u6d4b\uff0c\u5f88\u96be\u68c0\u6d4b\u5230\u6570\u91cf\u6781\u5c11\u7684MRD\u3002\u82e5\u8981\u6c42\u7cbe\u786e\u5ea6\u8fbe\u523010\u7684\u8d1f\u4e94\u6b21\u65b9\u81f310\u7684\u8d1f\u516d\u6b21\u65b9\u6c34\u5e73\uff0c\u5219\u9700\u8981\u4f9d\u8d56\u5176\u4ed6\u6280\u672f\u3002<\/div>\n
\u00a0<\/div>\n
\u88684 \u5e38\u89c1MRD\u68c0\u6d4b\u6280\u672f\u7684\u4f18\u70b9\u4e0e\u5c40\u9650[3]<\/div>\n\n
\n![\"RmFicvQBAkgCmDz3SgnnYiaJz7DE6EqzU4DMibRpJgT9RyTtZNpWGjyE0NL1DvMgzSlxziab3yo3HL7pt747eyUl0A\"\/](\"https:\/\/www.geneclub.net.cn\/wp-content\/uploads\/images\/RmFicvQBAkgCmDz3SgnnYiaJz7DE6EqzU4DMibRpJgT9RyTtZNpWGjyE0NL1DvMgzSlxziab3yo3HL7pt747eyUl0A.png\")
<\/figure><\/div>\n\n
<\/figure><\/div>\n\n\u4e8c\u4ee3\u9ad8\u901a\u91cf\u6d4b\u5e8f\u65b9\u6cd5\uff08NGS\uff09\u662f\u65b0\u5174\u7684MRD\u68c0\u6d4b\u65b9\u6cd5\uff0c\u53ef\u4ee5\u5728100\u4e07\u4e2a\u9aa8\u9ad3\u7ec6\u80de\u4e2d\u68c0\u6d4b\u51fa1\u4e2a\u764c\u7ec6\u80de\uff0c\u5e76\u4e14\u7ea6\u5728\u4e00\u5468\u5185\u5373\u53ef\u5f97\u51fa\u68c0\u6d4b\u7ed3\u679c\u3002\u56fd\u5185\u76ee\u524d\u7684\u5e94\u7528\u8fd8\u4e0d\u5b8c\u5584\uff0c\u4f46\u662f\u56fd\u9645\u8303\u56f4\u5185\u8fd1\u51e0\u5e74\u83b7\u6279\u7684MRD\u8bca\u65ad\u4ea7\u54c1\uff0c\u5982Adaptive Biotechnologies\u7684ClonoSEQ\u3001\u6216\u662fGuardant Health\u5728\u7ebd\u7ea6\u5dde\u7387\u5148\u83b7\u6279\u7684Guardant Reveal\u90fd\u91c7\u7528\u4e86NGS\u4f5c\u4e3a\u81ea\u5df1\u7684\u68c0\u6d4b\u624b\u6bb5\u3002<\/div>\n
\u00a0<\/div>\n
\u5c24\u5176\u5728\u8840\u6db2\u80bf\u7624\u9886\u57df\uff0cNGS\u65e9\u5df2\u53d7\u5230\u56fd\u5185\u5916\u4e13\u5bb6\u7684\u8ba4\u53ef\u548c\u63a8\u8350\u30022022\u7248\u300aNCCN\u591a\u53d1\u6027\u9aa8\u9ad3\u7624\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u300b\u30012021\u7248\u300aNCCN\u6025\u6027\u6dcb\u5df4\u7ec6\u80de\u767d\u8840\u75c5\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u300b\u548c2020\u7248\u300a\u4e2d\u56fd\u591a\u53d1\u6027\u9aa8\u9ad3\u7624\u8bca\u6cbb\u6307\u5357\u300b\u7b49\u6307\u5357\u4e2d\u5747\u63a8\u8350\u4e86NGS\u4f5c\u4e3aMRD\u68c0\u6d4b\u65b9\u6cd5\u3002<\/div>\n\n
\n![\"RmFicvQBAkgCmDz3SgnnYiaJz7DE6EqzU4tbHEiaghv5a7BxfaJgXmd8AIpxHtbD7A2Hl540PvgCnVXgf3DnjwhbQ\"\/](\"https:\/\/www.geneclub.net.cn\/wp-content\/uploads\/images\/RmFicvQBAkgCmDz3SgnnYiaJz7DE6EqzU4tbHEiaghv5a7BxfaJgXmd8AIpxHtbD7A2Hl540PvgCnVXgf3DnjwhbQ.png\")
<\/figure><\/div>\n\n
<\/figure><\/div>\n\n\u56fe1 \u57fa\u4e8e\u9ad8\u901a\u91cf\u6d4b\u5e8f\u7684MRD\u68c0\u6d4b\u6d41\u7a0b[3]<\/div>\n
\u5728\u6025\u8feb\u7684\u4e34\u5e8a\u9700\u6c42\u4e0b\uff0c\u56fd\u5185\u7684\u80bf\u7624NGS\u4f01\u4e1a\u4e5f\u56f4\u7ed5\u7740MRD\u68c0\u6d4b\u8fdb\u884c\u7740\u5bc6\u96c6\u5e03\u5c40\u3002\u5176\u4e2d\uff0c\u4e0d\u540c\u7684\u4f01\u4e1a\u9009\u62e9\u7684\u5e03\u5c40\u65b9\u5f0f\u5343\u5dee\u4e07\u522b\u3002\u6709\u7684\u4ee5\u4e34\u5e8a\u7814\u7a76\u4e3a\u6838\u5fc3\uff1b\u6709\u7684\u9009\u62e9\u4ece\u56fd\u5916\u5f15\u8fdb\u6210\u719f\uff1b\u8fd8\u6709\u7684\u9009\u62e9\u53bb\u56fd\u5916\u6ce8\u518c\u7533\u62a5\u3002<\/div>\n
\u00a0<\/div>\n
\u5728\u6211\u4eec\u5df2\u7ecf\u770b\u5230\u7684\u5e03\u5c40\u4e2d\uff0c\u6cdb\u751f\u5b50\u662f\u5c11\u6570\u5df2\u7ecf\u5c06MRD\u68c0\u6d4b\u4ea7\u54c1\u63a8\u8fdb\u5230\u5927\u89c4\u6a21\u5546\u4e1a\u5316\u7684\u4f01\u4e1a\u4e4b\u4e00\u3002\u5df2\u5728\u4f34\u968f\u8bca\u65ad\u9886\u57df\u62d4\u5f97\u5934\u7b79\u7684\u6cdb\u751f\u5b50\u5728MRD\u68c0\u6d4b\u65b9\u9762\u518d\u6b21\u5148\u884c\u4e00\u6b65\u3002<\/div>\n
\u00a0<\/div>\n
\u8fd1\u65e5\uff0c\u6cdb\u751f\u5b50\u4e0e\u590d\u661f\u533b\u836f\u7b7e\u8ba2\u4e86Seq-MRD\u00ae\uff08\u8840\u6db2\u80bf\u7624\u5fae\u5c0f\u6b8b\u7559\u75c5\uff09\u68c0\u6d4b\u670d\u52a1\u72ec\u5bb6\u5546\u4e1a\u5316\u5408\u4f5c\u534f\u8bae\u3002\u53cc\u65b9\u5c31\u63a8\u5e7fSeq-MRD\u00ae\u4ee5\u63d0\u5347\u5176\u5e02\u573a\u53ef\u53ca\u6027\u8fbe\u6210\u5171\u8bc6\uff0c\u5e76\u4e14\u53cc\u65b9\u8fdb\u884c\u4e86\u660e\u786e\u7684\u5206\u5de5\uff0c\u590d\u661f\u533b\u836f\u5c06\u5229\u7528\u9500\u552e\u961f\u4f0d\u548c\u6e20\u9053\u8d44\u6e90\u63a8\u5e7fSeq-MRD\u00ae\uff0c\u6cdb\u751f\u5b50\u5219\u5c06\u63d0\u4f9b\u79d1\u7814\u63a8\u5e7f\u3001\u5e02\u573a\u6d3b\u52a8\u3001\u4ea7\u54c1\u57f9\u8bad\u7b49\u76f8\u5173\u4e13\u4e1a\u652f\u6301\u3002<\/div>\n
\u00a0<\/div>\n
Seq-MRD\u00ae\u8fd9\u6b3e\u4ea7\u54c1\u6700\u65e9\u6765\u81ea\u4e8e2020\u5e7410\u6708\u6cdb\u751f\u5b50\u4e0e\u827e\u6c90\u6069\u4e4b\u95f4\u7684\u5408\u4f5c\u3002\u6cdb\u751f\u5b50\u76f4\u63a5\u62ff\u4e0b\u4e86\u8fd9\u6b3e\u4ea7\u54c1\u7684\u5168\u7403\u72ec\u5bb6\u8bb8\u53ef\uff0c\u5e76\u4e14\u5728\u539f\u672c\u4ea7\u54c1\u7684\u57fa\u7840\u4e4b\u4e0a\uff0c\u6cdb\u751f\u5b50\u8fd8\u8fdb\u4e00\u6b65\u7ed3\u5408\u4e86\u81ea\u5df1\u7684\u201c\u4e00\u6b65\u6cd5\u201d\u4e13\u5229\u6280\u672f\u5bf9Seq-MRD\u00ae\u8fdb\u884c\u4e86\u4f18\u5316\u3002<\/div>\n
\u00a0<\/div>\n
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<\/figure><\/div>\n\n
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\u00a0<\/div>\n
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\u00a0<\/div>\n
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\u00a0<\/div>\n
\u53c2\u8003\u8d44\u6599\uff1a<\/div>\n
1[1]\u00a0Liu W, Liu J, Song Y, et al. Mortality of lymphoma and myeloma in China, 2004-2017: an observational study. J Hematol Oncol. 2019;12(1):22. Published 2019 Mar 4. doi:10.1186\/s13045-019-0706-9<\/div>\n
[2]\u00a0Liu J, Liu W, Mi L, et al. Incidence and mortality of multiple myeloma in China, 2006-2016: an analysis of the Global Burden of Disease Study 2016. J Hematol Oncol. 2019;12(1):136. Published 2019 Dec 10. doi:10.1186\/s13045-019-0807-5<\/div>\n
[3]\u00a0S\u00e1nchez R, Ayala R, Mart\u00ednez-L\u00f3pez J. Minimal Residual Disease Monitoring with Next-Generation Sequencing Methodologies in Hematological Malignancies. Int J Mol Sci. 2019;20(11):2832. Published 2019 Jun 10. doi:10.3390\/ijms20112832<\/div>\n
\u00a0<\/div>\n
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