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目的:检测HOXB4、PRDM16及HOXA9在急性髓系白血病(AML)患者骨髓中的表达水平,探讨其临床意义。方法:采用实时荧光定量PCR方法,检测40例初治或复发AML患者、9例完全缓解患者和19例对照者(非恶性血液病患者及健康供者)骨髓细胞HOXB4、PRDM16及HOXA9 mRNA表达水平,分析其与疾病特征、临床疗效之间关系。结果:初治或复发AML患者骨髓细胞中HOXB4、PRDM16和HOXA9表达水平均明显高于非恶性血液病患者(P<0.05);初治或复发AML患者HOXB4基因表达水平与骨髓白血病细胞比例成正相关(r=0.39),HOXB4、PRDM16和HOXA9基因的表达水平两两之间具有相关性;AML不同病程阶段(初诊、复发、缓解)HOXB4、PRDM16基因表达水平差异具有统计学意义;按预后危险度分层将初治及复发AML患者分为高、中、低危3组,3组之间HOXB4、PRDM16、HOXA9表达水平的差异无统计学意义;经2个疗程正规化疗,缓解组(CR/PR)患者治疗前的3个基因表达水平均低于未缓解组治疗前水平(P<0.05);上述3个基因低表达组缓解率均高于高表达组(P<0.05)。结论:HOXB4、PRDM16、HOXA9基因表达水平与AML患者肿瘤负荷、疗效和预后存在一定的关系。在初治和复发的AML患者骨髓细胞高表达,缓解后其表达水平下降,表达高者化疗效果差,缓解率低。
Objective: To detect the expression of HOXB4, PRDM16 and HOXA9 in the bone marrow of patients with acute myeloid leukemia (AML) and to investigate their clinical significance. Methods: The mRNA expression of HOXB4, PRDM16 and HOXA9 in bone marrow of 40 patients with newly diagnosed or relapsed AML, 9 patients with complete remission and 19 controls (non-hematologic malignancies and healthy donors) were detected by real-time fluorescence quantitative PCR , Analyze its relationship with disease characteristics, clinical efficacy. Results: The expression levels of HOXB4, PRDM16 and HOXA9 were significantly higher in patients with newly diagnosed or relapsed AML than that in non-malignant hematological patients (P <0.05). The expression of HOXB4 in patients with newly diagnosed or relapsed AML was positively correlated with the proportion of myeloid leukemia (r = 0.39), HOXB4, PRDM16 and HOXA9 gene expression between the two levels have a correlation; AML different stages of the disease (newly diagnosed, relapsed, remission) HOXB4, PRDM16 gene expression differences were statistically significant; according to the prognostic risk There were no significant differences in the expression levels of HOXB4, PRDM16 and HOXA9 between the three groups in the three groups. After two courses of regular chemotherapy and remission (CR / PR) patients before treatment were lower than those before treatment (P <0.05). The remission rate of low expression group was higher than that of high expression group (P <0.05). Conclusion: The expression levels of HOXB4, PRDM16 and HOXA9 are related to tumor burden, efficacy and prognosis in AML patients. In untreated and relapsed AML patients with high expression of bone marrow cells, its expression decreased after remission, high expression of the chemotherapy effect is poor, low response rate.