NT5C2基因在儿童急性白血病中的表达及其临床意义  

NTSC2 expression in children with acute leukemia and its clinical significance

作　　者：王艳珍[1] 安曦洲 刘江华[1] 张妮[1] 刘志娟[1] 梁绍燕 于洁[1] 

机构地区：[1]重庆医科大学附属儿童医院血液肿瘤科,400014

出　　处：《中华血液学杂志》2015年第9期748-753,共6页Chinese Journal of Hematology

摘　　要：目的探讨核苷类似物代谢相关基因NT5C2在儿童急性白血病（AL）患者骨髓样本中的表达及其临床意义。方法采用实时荧光定量PCR和免疫组织化学染色法检测63例初诊、15例完全缓解和7例复发AL患JLNTSC2mRNA及蛋白水平，以16例非恶性血液系统疾病患儿作为对照。分析NT5C2在AL患儿中的表达及其与临床指标的关系。结果①NT5C2mRNA在初诊急性B淋巴细胞白血病（B—ALL）、急性T淋巴细胞白血病（T-ALL）、急性髓系白血病（AML）和对照组的表达水平分另0为1．16（0．89～2．25）、0．96（0．74～1．25）、I．66（0．84～3．15）币口0．88（0．61～1．21）。其中AML（P〈0．01）、B—ALL（P〈0．05）的表达水平显著高于对照组；T-ALL的表达水平与对照组相比差异无统计学意义（P〉0．05）。动态观察NT5C2mRNA在15例AL患儿不同治疗阶段的表达变化，完全缓解后表达水平明显降低（P〈0．01）。复发AL患儿的NT5C2mRNA水平显著高于缓解组及对照组（P〈0．01）。②免疫组织化学染色检测显示NT5C2蛋白水平与mRNA水平趋势一致。③在AML、T-ALL患儿组中NT5C2mRNA表达水平与危险度分级呈正相关（r值分别为0．434、0．389，P值均〈0．05）。@NT5C2高表达组AML患儿的诱导缓解化疗第9天骨髓不缓解率（35．2％对0）、巩固治疗前骨髓不缓解率（25．O％对0）、微小残留病阳性率（36．4％对14．3％）和复发率（38．5％对28．6％）均高于低表达组，但差异无统计学意义（P值均〉0．05）。结论NT5C2高表达是儿童AL预后不良相关危险因素，有望成为指导个体化化疗、判断预后、监测复发的指标。Objective To investigate the expression level and analyze the clinical significance of NTSC2, which is an nucleoside analogues metabolism related gene, in children with acute leukemia （AL）. Methods Real-time PCR and immunohistochemistry were presented to detect the level ofNTSC2 mRNA and its protein product cN- Ⅱ in bone marrow samples of 63 patients initially diagnosed with AL, 15 patients who achieved complete remission, 7 patients who relapsed and 16 non-hematologic malignancie controls. The expression of NT5C2 mRNA in different groups of AL and its relevance with clinical indicators were analyzed. Results ①The expression of NT5C2 mRNA in newly diagnosed B-ALL, T- ALL, AML and controls were 1.16（0.89-2.25）, 0.96（0.74-1.25）, 1.66（0.84-3.15） and 0.88（0.61-1.21 ）, respectively. NT5C2 mRNA expression in AML （P〈0.01 ） and B-ALL （P〈0.05） cases were higher than that in controls; NT5C2 mRNA expression in T-ALL and in controls showed no significant difference （P〉 0.05）. Changes of NTSC2 mRNA level were observed between preliminary diagnosis and complete remission in 15 patients. NTSC2 mRNA levels were significantly decreased in complete remission stage than that in newly diagnosis AL （P〈0.01）. NTSC2 mRNA levels of relapsed-refractory group were higher than that of complete remission group and controls （P〈0.01）. ②Immunohistochemical staining results revealed that NT5C2 protein levels were consistent with the trend of mRNA levels. ③NTSC2 mRNA levels in AML （t=0.434） and T-ALL （r=0.389）were positively correlated with risk classification （P〈0.05）. ④ During chemotherapy of patients with AML, the NR rate of bone marrow in NTSC2 high expression group was higher than that of low expression group after 9 days induction chemotherapy（35.2% vs 0） and before consolidation therapy （25.0% vs 0）; The positive rate of minimal-residual disease （36.4% vs 14.3% ）and relapse rate of AL （38.5% vs 28.6% ）were increased in NT5C2 high expressed patients t

关 键 词：基因 NT5C2 白血病 儿童 危险因素 核苷类似物耐药 

分 类 号：R733.71[医药卫生—肿瘤]