TET2基因在157例成人正常核型急性髓系白血病患者中的表达及其临床意义  

Clinical significance of TET2 gene expression in 157 adult acute myeloid leukemia patients with normal cytogenetics

作　　者：朱志娟[1] 陈健[1] 余梦霞[1] 陈菲菲[1] 陈志妹[1] 楼基余[1] 佟红艳[2] 黄健[2] 钱文斌[2] 孟海涛[2] 金洁[2] 

机构地区：[1]浙江大学医学院附属第一医院血液病研究所,杭州310003 [2]浙江大学医学院附属第一医院血液科

出　　处：《中华血液学杂志》2014年第9期802-807,共6页Chinese Journal of Hematology

摘　　要：目的 探讨TET2基因表达水平在成人正常核型急性髓系白血病（CN-AML）中的临床意义.方法 实时定量PCR方法检测157例成人CN-AML患者TET2基因表达水平,并分析其临床意义.结果 CN-AML患者骨髓单个核细胞和骨髓CD34＋细胞中TET2基因表达中位值均低于正常对照[7.29（3.41～9.99）对8.13（6.68～9.04）,6.02（5.64～6.54）对6.48（5.97～7.12）,P值分别为0.026和0.034）.CN-AML患者初发时TET2基因表达水平[7.32（6.11～8.41）]明显低于其完全缓解时[8.39（7.76～8.79）]（P＜0.01）.在157例CN-AML患者中,TET2基因低表达组18个月的总生存（OS）率[（32.7±5.9）％]明显低于高表达组[（48.6±6.9）％]（P=0.041）.在预后多因素分析中,TET2基因低表达是CN-AML患者OS和无事件生存的独立危险因素[风险比（HR）分别为2.032 （95％CI 1.272～3.247）和1.532 （95％CI1.014～2.314）,P值分别为0.003和0.043].结论 CN-AML患者TET2基因表达水平低于正常对照,TET2基因低表达的CN-AML患者预后较差,TET2基因低表达可作为CN-AML患者预后不良指标.Objective To explore the clinical significance of ten-eleven-translocationmethylcytosine dioxygenase 2 （TET2） mRNA expression levels in adult acute myeloid leukemia patientswith normal cytogenetics （CN-AML）.Methods Expression levels of TET2 mRNA were measured byreal-time PCR in 157 adult CN-AML,and its clinical impact in CN-AML was evaluated as well.ResultsTET2 gene expression levels from bone marrow mononuclear cells （BMMNCs） [7.29 （3.41-9.99）] andCD34＋ cells [6.02 （5.64-6.54）] in CN-AML were significantly lower than those [BMMNCs：8.13 （6.68-9.04）,P=0.026; CD34＋ cells：6.48 （5.97-7.12）,P=0.034] in healthy control.And TET2 mRNA level atdiagnosis [7.32 （6.11-8.41）] was obviously lower than that at complete remission [8.39 （7.76-8.79）,P＜0.01].CN-AML patients with lower levels of TET2 mRNA showed worse survival rate [（32.7±5.9）％] at18-month than those with higher levels [（48.6±6.9）％,P=0.041].In multivariate analysis,lower level ofTET2 mRNA was an independent prognostic factor for OS [hazard ratio （HR） 2.032,95％ confidenceinterval （CI） 1.272-3.247,P=0.003]and event-free survival [HR 1.532,95％ CI 1.014-2.314,P=0.043].Conclusions The level of TET2 mRNA is significantly lower in patients with CN-AML and it is anindependent negative prognostic factor.TET2 could be an important factor for the molecular-based riskstratification in CN-AML.

关 键 词：基因 TET2 基因表达 白血病 髓样 急性 预后 

分 类 号：R733.71[医药卫生—肿瘤]