EVI1基因阳性儿童急性淋巴细胞性白血病临床特征及免疫表型分析  

Clinical and immunophenotypic features of childhood acute lymphocytic leukemia with EVI1 gene positive

作　　者：姜敏[1,3] 金润铭[1] 杜雯[2] 李小青[2] 胡东[2] 吴介洪 蔡莎[2] 张志泉[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院儿科,武汉430022 [2]华中科技大学同济医学院附属协和医院干细胞中心,武汉430022 [3]三峡大学第一临床学院宜昌市中心人民医院儿科,宜昌443003

出　　处：《国际儿科学杂志》2014年第1期80-83,共4页International Journal of Pediatrics

摘　　要：目的 研究Evi1基因在儿童急性淋巴细胞性白血病（acute lymphoblastic leukemia,ALL）的表达及免疫表型特点.方法 采用逆转录-聚合酶链反应法和流式细胞仪检测2010年12月至2013年2月华中科技大学同济医学院附属协和医院儿科血液病区262例ALL EVI1基因的表达及免疫表型,比较EVI1基因表达阳性与表达阴性患儿的免疫表型及临床特征的差异.结果 262例ALL患儿有29例EVI1基因表达阳性.EVI1表达阳性与表达阴性的ALL患儿相比,EVI1阳性的ALL患儿初诊外周血白细胞计数增高,血小板下降,女性患儿所占比例高,强的松试验敏感者明显减少,第一疗程诱导缓解率明显降低（P＜0.05）,而年龄、血红蛋白含量差异无统计学意义（P＞0.05）.EVI1阳性的B系ALL高表达cCD79a、CD38、CD10、CD19、CD22,CD123、TDT、HLADR、CD34,T系ALL高表达CD2、CD3、CD4、CD5、CD7、CD8、CD38、cCD3.B系EVI1阳性组与阴性组相比,B系EVI1阳性组CD13、CD33、CD11b等髓系相关抗原表达增加,CD19、CD20、CD22等B细胞相关抗原表达减少（P＜0.05）.结论 EVI1基因表达阳性的ALL是一种特殊类型的白血病亚型,近期预后差.B系EVI1阳性ALL患儿部分髓系相关抗原表达增加,部分B细胞相关抗原表达减少.Objective To study the expression of Ecotropic viral integration site （EVIl） gene and clini- cal and immunopbenotypic features of childhood acute lymphoblasfic leukemia（ALL）. Methods The expres- sion of EVIl gene and immunophenotyping of 262 children with acute lymphocytic leukemia in Department of Pediatric Hematology, Union Hospital, Tongji Medical College , Huazhong University of Science and Technology from Dec. 2010 to Feb. 2013 were detected by RT-PCR and flow cytometry. Immunopbenotypic and clinical fea- tures were compared between childhood with EVIl gene positive and negetive. Resets We identified 29 ALL with EVIl gene positive among 262 childhood acute lymphocytic leukemia, the incidences positive expression was 11.07%. There was no signficant difference with respect to age,sex,hemoglobin between ALL with EVIl positive and negetive respectively（ P 〉 0.05 ） ,but ALL with EVIl positive had higher white blood cell count, lower platelet count in initial peripheral blood and more female children（ P 〈 0.05 ）. The number of prednisone good-response and complete remission of the first course of treatment was significantly decreased in ALL with EVIl positive（P 〈0.05）. The expression of EVIl gene was detected in both B-ALL and T-ALL respectively, and there was no signficant difference in expression incidence （ P 〉 0.05 ）. cCD79a, CD38, CD10, CD19, CD22, CD123,TDT, HLADR, CD34 were highly expressed in B-ALL with EVIl gene positive. CD2, CD3, CD4, CD5 ,CD7,CD8, CD38, cCD3 were highly expressed in T-ALL with EVIl gene positive. The expression of CD19, CD20, CD22 in B-ALL with EVIl gene positive was signficantly lower and CD13, CD11 b, CD33 was signficantly higher than B-ALL with EVIl negative（ P 〈 0.05 ）. Conclusion ALL with EVIl gene positive is a relatively rare subtype of leukemia and the recent prognosis was poor. The expression of parts of myeloid line- age-associated antigens are signficantly higher, and parts of B lymphiod lineage-associated antigens are signfi- cantly low

关 键 词：EVI1基因 急性淋巴细胞性白血病 免疫分型 儿童 

分 类 号：R733.71[医药卫生—肿瘤]