初治成人急性髓系白血病患者ERG基因的表达水平及其与预后的相关性分析  

Detection of the expression of ERG gene in adult patients with de novo acute myeloid leukemia and its prognostic implications

作　　者：郭绪涛[1] 徐兵[1] 査洁 刘秉珊[1] 张妍琰[1] 周淑芸[1] 

机构地区：[1]南方医科大学南方医院血液科,广州510515

出　　处：《临床血液学杂志》2012年第1期13-15,18,共4页Journal of Clinical Hematology

基　　金：广东省科技计划项目基金资助项目(No:2007B030704010)

摘　　要：目的:研究成人急性髓系白血病(AML)患者ETS相关基因(ERG)的表达水平及其与临床预后的相关性。方法:构建实时荧光定量检测ERG基因表达的PCR技术,定量检测123例初治成人AML患者骨髓ERG基因的表达水平并分析其与临床疗效及预后的关系。结果:初治AML组ERG基因表达显著高于正常对照组(P<0.01),初治AML患者ERG基因表达的水平与外周血原始幼稚细胞比例成正相关(P<0.05),而与血清LDH水平、外周WBC、Hb水平、PLT、骨髓原始幼稚细胞比例无明显相关性(P>0.05)。尽管在全部初治AML患者中ERG基因高表达组的完全缓解(CR)率(66.7%)与低表达组(80.0%)比较差异无统计学意义(P>0.05),但在正常核型初治AML患者中,ERG基因高表达AML患者的CR率显著低于ERG低表达组(55.6%vs86.5%,P<0.05)。对105例AML患者进行随访(中位随访时间490d)发现,正常核型AML中ERG高表达组总生存率(OS)显著低于ERG低表达组(33.3%vs 64.3%,P<0.05)。结论:ERG基因高表达很可能是正常核型AML一个重要的预后不良因素;检测初治AML患者ERG基因的表达水平有助于判定预后,指导分层治疗。Objective：To investigate the expression of ERG gene in adult patients with de novo acute myeloid leukemia（AML） and its prognostic implications. Method： We analyzed the expression of ERG gene in bone marrow samples of 123 de novoadult AML patients by real-time fluorescent quantitative polymerase chain reaction （RQ- PCR）. Patients were divided into quartiles according to the ERG expressive levels and were compared for clinical outcome. Result：The expression of ERG gene was significantly higher in AML cases than in control group （P〈 0.01）. High ERG expression was associated with higher peripheral blood blast counts（P〈0.05）. The ERG expression level was not correlated with lactate dehydrogenase（LDH）,WBC, Hb level, PLT, and bone marrow blast counts（P〉0.05）. There was no significant difference of complete remission（CR） rates and overall survival（OS） between high ERG expression group and low ERG expression group （P〉 0. 05）. .However, among the patients with cytogenetically normal（CN） AML,high ERG expression group had a lower CR rate （55.6%vs 86.5% ,P〈 0.05） and a shorter OS （33.3% vs 64.3% ,P〈0.05） than low ERG expression group. Conclusion.. High expression of ERG might be defined as an important risk factor in CN-AML patients and predict poor prognosis. The prognostic impact of ERG may assist treatment stratification and suggest the need Of alternative regimens.

关 键 词：白血病 髓系 急性 ERG基因 预后 

分 类 号：R733.71[医药卫生—肿瘤]