急性白血病中黏蛋白1基因的表达及其临床意义  

Expression and clinical significance of MUC1 gene in acute leukemia

作　　者：李旭东[1,2] 王东宁[1,2] 何易[1,2] 胡元[1,2] 王文文[1,2] 林东军[1,2] 黄仁魏[1,2] 

机构地区：[1]中山大学附属第三医院血液科 [2]中山大学血液病研究所,广州510630

出　　处：《新医学》2013年第3期176-179,共4页Journal of New Medicine

基　　金：广东省科技计划项目(2010B080701006)

摘　　要：目的:观察各型急性白血病(AL)中黏蛋白1(MUC1)基因的表达及其与疗效及复发的关系,为MUC1基因成为监测病情变化、判断预后的分子生物学指标提供理论依据。方法:采用逆转录-PCR(RT-PCR)方法检测292例AL患者初治、治疗后获完全缓解(CR)时MUC1基因的表达,并观察MUC1已转阴性的患者再次转阳时与临床复发的关系。结果:292例初治AL患者中MUC1阳性156例(53.4%),其中215例急性髓细胞白血病(AML)中MUC1阳性123例(57.2%),M1阳性率为42.9%,M2为50%,M3为46.4%,M4为75%,M5为73.9%,M6为33.3%。69例急性淋巴细胞白血病(ALL)中MUC1阳性30例(43.5%)。8例急性混合细胞白血病(AMLL)中MUC1阳性3例(37.5%)。156例MUC1阳性者治疗后CR112例(71.8%),136例阴性患者CR 125例(91.9%),两组比较差异有统计学意义(P<0.05)。选取治疗前为MUC1阳性的112例CR患者中56例AML及17例ALL患者进行观察,CR时MUC1均由阳性转阴性,其中5例AML及6例ALL随后再出现MUC1转阳性,9例行异基因造血干细胞移植后无复发,2例未移植者临床复发。结论:MUC1基因在AML-M4、M5的表达最高;MUC1阳性者CR率低,治疗效果差;通过检测MUC1基因可提前监测AL复发。Objectives： To study the expression of MUC1 in different subtype acute leukemia （AL） and the relationship between expression of MUC1 and clinical effects for AL, and offer theoretical basic for MUCI gene as a molecular biologic marker of detecting MRD and estimating the prognosis in AL. Methods： To test the expression of MUC1 in 292 AL cases at initial and CR stage by RT-PCR, and study the relationship between relapse and ex- pression of MUC1 when it turned into positive although negtive already. Results： Expression of MUC1 gene were positive in 156 of all 292 （53.4%） AL patients. Among 215 AML, 123 （57.2%） were positive, and the rate was42.9% inM1,50% inM2,46.4% inM3,75% inM4,73.9% inM5, 33.3% inM6. 30of69 （43.5%） ALL and 3 of 8 （37.5%） AMLL patients were positive; 112 （71.8%） cases got CR of 156 positive patients, and 125 （91.9%） got CR of 136 passive patients. The difference was significant. MUC1 gene turned into passive in 56 AML and 17 ALL of 112 positive patients when they got CR. Among them, 5 AML and 6 ALL returned into positive following. 9 cases survived free relapse after Allogeneic hematopoietic stem cell transplantation, and 2 ca- ses relapsed soon who without transplantation. Conclusions： Expression of MUC1 gene is high in AML patients, especially M4 and MS. MUC1- passive AL patients have better therapeutic efficacy than positive cases. The expres- sion of MUC1 gene can be used as a tool of detecting minimal residual disease and diagnosing the early relapse before clinical relapse.

关 键 词：白血病 黏蛋白1基因 复发 

分 类 号：R733.71[医药卫生—肿瘤]