PRAME基因在小儿急性白血病患者中的表达及其与预后的相关性  

Preferentially Expressed Antigen of Melanoma Expression and Its Correlation with Prognosis in Children with Acute Leukemia

作　　者：范小菊[1] 梁昌达[1] 钟小红[1] 谢淑佩[1] 

机构地区：[1]江西省儿童医院血液科,南昌330006

出　　处：《南昌大学学报（医学版）》2012年第3期45-48,共4页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨小儿急性白血病(acute leukemia,AL)患者骨髓单个核细胞(BMMNC)PRAME(preferentiallyexpressed antigen of melanoma)基因的表达及其与预后的相关性。方法采用半定量逆转录聚合酶链反应(RT-PCR)方法检测95例AL患者PRAME mRNA的表达水平,并将检测结果进行分析。结果 PRAME阳性表达率:ANLL为60.0%,ALL为56.9%,2组比较差异无统计学意义(P>0.05),而完全缓解组(complete remission,CR)及对照组PRAME均阴性;在ANLL中,以M3、M2、M4亚型的阳性检出率较高,分别为75.0%、62.5%、60.0%;有效组PRAME的表达水平显著低于无效组(P<0.01);对8例初治时PRAME高表达患儿进行随访,化疗CR后均转阴,分别在CR后6个月～1年的不同时间内复发,其中5例PRAME再次升高早于临床复发,3例在临床复发时再次升高。结论 PRAME基因是小儿急性白血病的一个重要标记基因,动态检测PRAME的表达水平可在一定程度上了解疾病的状态和体内白血病细胞的总负荷量,对小儿AL患者的化学治疗、预后判断及监测微小残留病灶(minimal residual disease,MRD)、防治复发有一定的意义。Objective To investigate the expression of preferentially expressed antigen of melanoma（PRAME） in bone marrow mononuclear cells and its correlation with prognosis in children with acute leukemia（AL）.Methods The levels of PRAME were measured by semiquantitative reverse transcription polymerase chain reaction and the results were analyzed in 95 children with AL.Results There were no significant differences in the positive rates of PRAME between ANLL patients and ALL patients（60.0% vs 56.9%,P0.05）.No PRAME expression was detected in patients with complete remission（CR） and normal control subjects.In ANLL patients,the positive rates of PRAME for M3,M2 and M4 subtypes were 75.0%,62.5% and 60.0%,respectively.The levels of PRAME expression in effective group were significantly lower than those in ineffective group（P0.01）.Eight patients with high expression of PRAME before chemotherapy were followed-up.After chemotherapy,all 8 patients achieved CR with negative PRAME expression.However,the recurrence occurred 6-12 months after CR.Among the 8 patients,the levels of PRAME expression increased again before clinical recurrence in 5 and in clinical relapse in 3.Conclusion PRAME is a marker gene for pediatric AL.Dynamic detection of PRAME expression can evaluate the development of disease and total load of leukemic cells.Therefore,it is important to guide chemotherapy,predict relapse,monitor minimal residual disease and prevent relapse in children with AL.

关 键 词：PRAME基因 小儿急性白血病 预后 

分 类 号：R733.7[医药卫生—肿瘤]