GATA-2基因高表达在AML1/ETO阳性急性髓系白血病中的临床意义  

GATA-2 Gene Overexpression and Its Clinical Significance in Acute Myeloid Leukemia with AML1/ETO Fusion Gene

作　　者：谢惠敏[1] 高丽[2] 王楠[1] 徐媛媛[1] 李永辉[1] 于力[1] 王莉莉[1] 

机构地区：[1]中国人民解放军总医院血液科,北京100853 [2]中日友好医院血液科,北京100029

出　　处：《四川大学学报（医学版）》2014年第4期664-669,共6页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金(No.81370636;No.81170517;No.30973394);北京市自然科学基金(No.7102142)资助

摘　　要：目的探讨GATA-2基因在AML1/ETO融合基因阳性急性髓系白血病M2（acute myeloid leukemia with maturation,AML/M2）患者中的表达状况。方法利用实时荧光定量PCR（RQ-PCR）法对23例AML1/ETO阳性AML-M2患者初诊骨髓标本中GATA-2基因的表达情况进行定量检测,并分析不同表达水平患者实验室检查及临床预后的差异。结果患者GATA-2基因表达水平（GATA-2基因拷贝数/内参基因拷贝数）初诊时为2.17%~1 260.65%。将GATA-2基因表达水平≥82%者归为高表达组（10例）,表达水平〈82%者归为低表达组（13例）。高表达组与低表达组患者年龄、性别、初始白细胞计数、骨髓原始细胞比例以及化疗完全缓解（CR）率的差异均无统计学意义（P〉0.05）,但复发率（71.43%vs.15.38%）及死亡率（70.00%vs.7.69%）的差异有统计学意义（P均〈0.05）,高表达组的无病生存（DFS）率及总生存（OS）率亦低于低表达组（P〈0.01）。在高表达组中,选择移植（2/10）者均无复发存活,选择单纯化疗（8/10）的患者7例死亡。结论 AML1/ETO阳性AML-M2患者合并GATA-2基因高表达提示患者易复发且预后不良,此类患者应尽早采取常规化疗以外的其他有效治疗措施。Objective To determine the expression level of GATA-2gene in acute myeloid leukemia with maturation（AML-M2）patients carrying AML1/ETOfusion gene.Methods Bone marrow samples were collected from 23patients with de novo adult AML-M2carrying AML1/ETOfusion gene.GATA-2gene expression was detected by real-time quantitative polymerase chain reaction（RQ-PCR）.We analyzed the correlation between GATA-2gene expression and laboratorial features and clinical prognosis of patients.Results GATA-2expression levels（GATA-2gene copies/reference gene copies）in the patients were found to be 2.17%-1 260.65%.AGATA-2expression over or equal to 82% was defined as HIGH（10cases）,while an expression level below 82% was defined as LOW（13cases）.No significant differences were found in age,sex,white blood cell count or the rate of bone marrow blasts between HIGH and LOW expression groups（P＆gt;0.05）.Although the difference in complete remission rate between the two groups was not statistical significant（P=0.067 8）,the HIGH expression group had higher relapse rate（71.43% vs.15.38%,P=0.022 3）and higher mortality rate（70.00% vs.7.69%,P＆lt;0.05）.The DFS and OS of the HIGH group are statistically significantly lower than that of the LOW group（P＆lt;0.01）.In the HIGH group,the patients choosing HSCT（2/10）are all alive without relapse,while among those choosing chemotherapy only（8/10）,seven out of eight patients died.Conclusion High expression level of GATA-2in AML-M2patients with AML1/ETOis associated with high risk of relapse and poor prognosis.Therefore,AML-M2patients with AML1/ETOfusion gene and high expression of GATA-2 would possibly benefit from additional treatments except for chemotherapy.

关 键 词：急性髓系白血病 AML1 ETO GATA-2 定量PCR检测 预后评估 

分 类 号：R733.71[医药卫生—肿瘤]