SIRT1在急性髓系白血病患儿骨髓活检组织中的表达及临床意义  

Expression of SIRT1 in bone marrow biopsy tissues and its clinical significance among children with acute myeloid leukemia

作　　者：刘晓明 周剑峰 张培红 阮敏 张丽 邹尧 陈玉梅 竺晓凡 

机构地区：[1]中国医学科学院、北京协和医学院血液病医院/血液学研究所儿童血液病诊疗中心,天津300020 [2]中国医学科学院、北京协和医学院血液病医院/血液学研究所病理中心,天津300020

出　　处：《中国当代儿科杂志》2014年第6期614-618,共5页Chinese Journal of Contemporary Pediatrics

基　　金：科技部重大专项(2011ZX09302-007-04);天津市科技支撑计划(12ZCDZSY18100)

摘　　要：目的 了解SIRTl在急性髓系白血病（AML）患儿骨髓活检组织中的表达水平,并分析其与AML预后的相关性。方法 回顾性分析2009年7月至2012年4月确诊为AML并于初诊时行骨髓活检检查的54例患儿的临床资料。采用免疫组织化学染色方法检测患儿骨髓活检组织中SIRTl的表达;根据SIRT1的表达情况将病例分为SIRT1阴性组（n=10）和SIRT1阳性组（n=44）,再根据SIRT1表达的阳性程度进一步将SIRT1阳性组分为（＋）组（n=8）、（2＋）组（n=7）和（3＋）组（n=29）,比较各组患儿的预后。Cox多因素回归分析患儿长期生存的危险因素。结果 SIRT1（3＋）组病死率明显高于SIRT1阴性组（P〈0.05）。SIRT1阳性组2年总生存率低于SIRT1阴性组（P〈0.05）;2年无事件生存率亦低于SIRT1阴性组（P〈0.05）。Cox多因素回归分析显示SIRT1阳性表达不利于患儿的长期生存（P=0.045,危险系数绝对值=2.071,95%CI：1.017~4.219）。结论 部分AML患儿骨髓活检组织存在SIRTl表达增高情况,且SIRTl高表达与不良预后相关。Objective To determine the expression level of silent mating-type information regulation 2 homologue 1（SIRT1） in bone marrow biopsy tissues among children with acute myeloid leukemia（AML） and analyze its relationship with the prognosis of AML patients.Methods A retrospective analysis was performed on the clinical data of 54 children who were diagnosed with AML between July 2009 and April 2012 and who underwent bone marrow biopsy at diagnosis.The expression of SIRT1 in bone marrow was measured by immunohistochemistry.The 54 patients were divided into two groups according to the expression of SIRT1： SIRT1-negative（n=10） and SIRT1positive（n=44）.The SIRT1-positive group was further divided into three subgroups： SIRT1（＋）（n=8）,SIRT1（＋＋）（n=7） and SIRT1（＋＋＋）（n=29） according to the expression levels of SIRT1.Cox multivariate regression analysis was used to determine the unfavorable factors for long survival in children with AML.Results The SIRT1（＋＋＋） subgroup had a significantly higher mortality than the SIRT1-negative group（P＆lt;0.05）.Compared with the SIRT1-negative group,the SIRT1-positive group had a significantly lower 2-year overall survival rate（P＆lt;0.05） and a significantly lower 2-year event-free survival rate（P＆lt;0.05）.Cox multivariate regression analysis showed that positive expression of SIRT1 was an unfavorable factor for long-term survival in children with AML,with a risk coefficient of 2.071（95% CI： 1.017-4.219;P=0.045）.Conclusions SIRT1 is overexpressed in some of pediatric AML patients,and the overexpression of SIRT1 is associated with poor prognosis.[Chin J Contemp Pediatr,2014,16（6）： 614-618]

关 键 词：急性髓系白血病 预后 SIRTl 儿童 

分 类 号：R733.71[医药卫生—肿瘤]