急性白血病患者DNA甲基转移酶基因的表达其及临床意义  

Clinical Significance of the Expression of DNA Methyltransferase Genes (DNMT) in Acute Leukemia Patients

作　　者：乔淑凯[1] 徐世荣[1] 郭晓楠[1] 王颖[1] 

机构地区：[1]河北医科大学第二医院血液内科,石家庄050000

出　　处：《中国实验血液学杂志》2005年第2期260-265,共6页Journal of Experimental Hematology

摘　　要：为了探讨DNA甲基转移酶(DNMT)基因在成人急性白血病(AL)患者中的表达及其与临床预后之间的 关系,对72例AL患者和20例正常人的骨髓采用RT-PCR方法进行DNMT、p15INK4B、mdrl mRNA水平的检测;对 56例AL患者和14例正常人p15INK4B基因启动子区域CpG岛甲基化率,采用甲基化特异性PCR方法进行检测。结 果表明:AL患者组所有3种DNMT表达均明显高于对照组(P<0.01),改用细胞增殖核抗原(PCNA)为内对照, 差别仍有统计学意义。AL患者3种DNMT基因表达之间呈明显正相关,表现为协同的高表达;p15INK4B、mdrl与 DNMT表达呈明显负相关。DNMT因同时阳性患者组完全缓解(CR)率明显高于DNMT基因部分阳性或阴性 患者组(P<0.01)。p15INK4B基因在56例AL患者中,31例(55.4％)完全甲基化,12例(21.4％)部分甲基化,14例 正常人在同一条件下则无1例甲基化。结论:DNMT基因在成人AL患者有异常高表达,其可能通过促使抑癌基因 启动子区域过甲基化,而使其转录失活,从而导致白血病恶性克隆的形成。对于高表达DNMT的AL患者,可能对 化疗更敏感,提示DNMT基因高表达可能是临床预后较好的指标。To investigate the relationship between the expression of DNMT and clinical prognosis in adult patients with acute leukemia(AL), the mRNA expressions of DNMT, p15INK4B, mdrl were measured in 72 AL patients and 20 normal controls by semi-quantitative reverse transcription polymerse chain reaction (RT-PCR); the ratio of p15 CpG land methylation was measured in 56 AL patients and 14 normal controls by methylation-specific PCR (MSP-PCR). The results showed that all three DNMT mRNA expressions in AL patients were significantly higher than that in normal controls (P<0. 01). When the internal control was changed into PCNA, a kind of cell proliferation marker gene, the difference still showed a statistic significance. All three DNMT genes were significantly expressed and positively correlated with AL patients, showing high synergistic expression, and there was a negative correlation between the levels of p15, mdrl gene expression and DNMT. The complete remission (CR) rate in AL patients with the positive expression of all DNMT genes was significantly higher than that of AL patients with partially positive or negative expression ( P <0. 01) of DNMT genes. In 56 AL patients , the p15INK4B was completely methylated in 55.4% (31 of 56), partly methylated in 21.4% (12 of 56) and all 14 cases of normal controls were not methylated. It is concluded that DNMT genes are abnormally high expressed in adult AL patients, which lead to methylation-silence of tumor suppressor genes by CpG land hypermethylation, the AL patients with high expression of DNMT are more sensitive to chemotherapy, which may be a good prognostic factor for AL patients.

关 键 词：急性白血病 DNA甲基转移酶 DNA甲基转移酶基因 

分 类 号：R733.71[医药卫生—肿瘤]