论文部分内容阅读
本研究旨在检测白血病干/祖细胞(LSPC)相关基因ABCB1、BMI-1、HOXB4在急性白血病患者骨髓中的表达,并探讨其在急性白血病中的临床意义。采集41例初治急性白血病患者的骨髓、16例缓解期患者的骨髓及10例非恶性血液病患者骨髓标本(作为对照)。采用SYBR Green相对定量RT-PCR法检测ABCB1、BMI-1、HOXB4基因的表达水平,并分析它们与急性白血病疗效、预后的关系。结果表明,ABCB1、BMI-1、HOXB4在对照组均无表达,在初治组相对表达量分别为4.26±2.26、3.72±1.91、3.74±2.38;而在缓解标本组分别为2.14±1.47、2.07±0.99、1.47±0.89,均明显低于初治组(p<0.05);正规化疗2个疗程内能够获得完全/部分缓解的患者的基因相对表达量分别为1.77±1.29、2.09±1.26、1.78±1.49,明显低于未缓解的难治病例(分别为7.23±1.78、3.96±0.92、4.48±2.57)(p<0.01)。单因素分析发现,各个基因高表达患者的白血病干/祖细胞免疫表型(CD34+CD38-CD96+和CD34+CD38-CD123+)表达阳性的比例及出现高白细胞(≥30×109/L)的几率均高于低表达患者,差异显著(p<0.05);而综合分析各个基因的表达,上述变化的p值均小于单因素分析p值,差异更显著(p<0.01)。结论:LSPC相关基因(ABCB1、BMI-1、HOXB4)表达与LSPC免疫表型呈相关性,在急性白血病患者发病初期表达增高,缓解后其表达水平明显下降;表达高者易出现高白细胞,化疗效果差,缓解率低。综合多指标分析可能是一种更好地临床评估疗效和预后的方法。
This study was designed to investigate the expression of ABCB1, BMI-1 and HOXB4 genes in the bone marrow of patients with acute leukemia and to investigate their clinical significance in acute leukemia. Bone marrow from 41 patients with newly diagnosed acute leukemia, bone marrow from 16 patients with remission, and 10 patients with non-hematologic malignancies were collected as controls. The expression levels of ABCB1, BMI-1 and HOXB4 genes were detected by SYBR Green relative quantitative RT-PCR, and their relationship with the curative effect and prognosis of acute leukemia were analyzed. The results showed that ABCB1, BMI-1 and HOXB4 were not expressed in the control group, the relative expression levels in the untreated group were 4.26 ± 2.26, 3.72 ± 1.91 and 3.74 ± 2.38, respectively; while in the relief group were 2.14 ± 1.47 and 2.07 ± 0.99 and 1.47 ± 0.89, respectively, which were significantly lower than those in the untreated group (p <0.05). The relative gene expression of patients who achieved complete / partial remission within two courses of formal chemotherapy were 1.77 ± 1.29, 2.09 ± 1.26 and 1.78 respectively ± 1.49, which was significantly lower than the untreated cases (7.23 ± 1.78, 3.96 ± 0.92, 4.48 ± 2.57, respectively) (p <0.01). Univariate analysis showed that the percentage of leukemic stem / progenitor immunophenotypes (CD34 + CD38-CD96 + and CD34 + CD38-CD123 +) positive and high white blood cells (≥30 × 109 / L) were significantly higher in patients with high expression of each gene (P <0.05). However, the p values of all the above genes were all lower than those of the univariate analysis (p <0.01). Conclusions: The expression of LSPC related genes (ABCB1, BMI-1, HOXB4) is correlated with the immunophenotype of LSPC, the expression of LSPC is higher in the early stage of acute leukemia, and the expression level of LSPC is significantly lower after high-leukemia; Poor effect, low response rate. Comprehensive multi-index analysis may be a better clinical evaluation of the efficacy and prognosis of the method.