AML1/ETO阳性急性髓系白血病患者galectin-3的表达及临床意义  

Galectin-3 Expression and Its Clinical Significance in Acute Myeloid Leukemia with Positive AML1/ETO Fusion Gene

作　　者：高娜 王学霞[1] 孙建荣[1] 段培锋[2] 刘增艳[1] 刘仁同[1] 刘晓丹[1] 孙洪坤[1] 刘晓 于文征[1] GAO Na;WANG Xue-xia;SUN Jian-rong;DUAN Pei-feng;LIU Zeng-yan;LIU Ren-tong;LIU Xiao-dan;SUN Hong-kun;LIU Xiao;YU Wen-zheng(Department of Hemotology,Binzhou Medical University Hospital,Binzhou 256603,China;Department of Pediatrics,Binzhou Medical University Hospital,Binzhou 256603,China)

机构地区：[1]滨州医学院附属医院血液科,滨州256603 [2]滨州医学院附属医院儿科,滨州256603

出　　处：《四川大学学报（医学版）》2019年第1期109-114,共6页Journal of Sichuan University(Medical Sciences)

基　　金：山东省医药卫生科技发展计划项目(No.2015WS0508)资助

摘　　要：目的探讨AML1/ETO阳性急性髓系白血病(AML1/ETO+AML)患者半乳凝集素3(galectin-3,gal-3)表达及其临床意义。方法采用实时定量RT-PCR(RQ-PCR)法检测53例AML1/ETO+AML患者骨髓单个核细胞中gal-3mRNA表达水平,ELISA法检测患者外周血gal-3蛋白水平,分析gal-3mRNA表达与疾病预后的相关性。结果 (1)gal-3mRNA及蛋白在初诊AML1/ETO+AML患者中呈高表达(P<0.001),初诊患者gal-3mRNA与蛋白表达呈正相关(r=0.732,P<0.001),疾病完全缓解期外周血gal-3蛋白表达量下降(P<0.001);(2)初诊时gal-3mRNA表达水平越高,患者白细胞数量越低(P=0.014),CD34表达和附加染色体异常的比例越高(P=0.001,P=0.026);(3)gal-3mRNA高表达组与低表达组在完全缓解(CR)、部分缓解(PR)、诱导期死亡(即早期死亡)率上无明显差异(P>0.05),但两组患者在复发率上差异有统计学意义(P=0.029);(4)gal-3mRNA高表达组患者中位总生存率(OS)及无病生存率(DFS)均较低表达组缩短(P=0.007,P=0.015),累积复发率增高(P=0.045),但累积死亡率无明显差异(P>0.05)。Cox风险比例模型提示gal-3mRNA是影响AML1/ETO+AML患者OS及DFS的独立指标。结论骨髓gal-3mRNA有可能成为AML1/ETO+AML患者评估预后及指导治疗的重要参考指标。Objective To investigate the mRNA expression of galectin-3and its clinical significance in acute myeloid leukemia(AML)patients carrying AML1/ETOfusion gene.Methods RQ-PCR method was used to detect the expression of galectin-3 mRNA in bone marrow mononuclear cells of 53 AML patients with AML1/ETO^+,ELISA was used to detect the expression of galectin-3protein in peripheral blood,and the correlations of galectin-3expression with clinical and laboratory features and outcomes were analyzed.Results The mRNA and protein levels of galectin-3were significantly higher in newly diagnosed AML1/ETO+AML patients compared with the control(P<0.001).Galectin-3 mRNA and protein expressions were positively correlated(r=0.732,P <0.001).Galectin-3protein was significantly decreased during the period of complete remission(CR)(P<0.001).The mRNA expression of galectin-3 was negatively correlated with the count of white blood cells(P=0.014),and positively correlated with CD34 expression and additional cytogenetic aberrations(ACA)(P=0.001,P=0.026).There was no significant difference in CR,partial remission(PR),induction death(early mortality)between galectin-3high-expression group and low-expression group(P >0.05),but there was significant difference in recurrence rate between the two groups(P=0.029).The median overall survival(OS)rate and disease-free survival(DFS)rate were shortened in the high-expression group(P=0.007,P=0.015)and the cumulative incidence of relapse was increased(P=0.045),but there was no significant difference in the cumulative incidence of mortality(P >0.05).Cox regression analysis suggested galectin-3mRNA level an independent indicator of OS and DFS in AML1/ETO^+AML patients.Conclusion Bone marrow galectin-3 mRNA level may be an important reference index for evaluating the prognosis and guiding the treatment of AML1/ETO^+AML patients.

关 键 词：GAL-3 mRNA 急性髓系白血病 AML1/ETO 预后 

分 类 号：R733.71[医药卫生—肿瘤]