儿童急性B前体淋巴细胞白血病铁转出蛋白表达水平与其临床特征和预后相关性研究  

Ferroportin expression of correlation with clinical features and prognosis in childhood precursor B-cell acute lymphoblastic leukemia

作　　者：霍婉莹 袁粒星 吴剑蓉[1] 杨雪[1] 艾媛[1] 郭霞[1] 蒋鸣燕[1] 万智[1] 高举[1] 

机构地区：[1]四川大学华西第二医院儿科/儿童血液肿瘤科,成都610041 [2]四川大学华西第二医院西部妇幼医学研究院公共实验室

出　　处：《中华妇幼临床医学杂志（电子版）》2016年第2期164-172,共9页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：四川省科技厅应用基础计划项目(2015JY0044)

摘　　要：目的探讨儿童急性B前体淋巴细胞白血病（BCP-ALL）铁转出蛋白（Fpn）表达水平与其临床特征和预后的关系。方法选择2011年2月至2014年6月四川大学华西第二医院收治的64例BCP-ALL患儿为研究对象,纳入研究组。对其统一按照中国儿童白血病协作组（CCLG）-急性淋巴细胞白血病（ALL）2008方案进行分型诊断和治疗。采用随机数字表法随机选择同期于本院健康体检的21例健康儿童,纳入对照组。采用荧光定量逆转录-聚合酶链反应（RT-PCR）技术分别检测研究组BCP-ALL患儿初诊时及对照组受试者体检时骨髓和外周血单个核细胞的Fpn表达水平。以Fpn相对表达量（0.18）为界值进行划分,研究组Fpn相对表达量〉0.18为Fpn高表达患儿,纳入Fpn高表达亚组（n=32）,Fpn相对表达量≤0.18为Fpn低表达患儿,纳入Fpn低表达亚组（n=32）。采用Kaplan-Meier法计算研究组患儿无复发生存（RFS）率、无事件生存（EFS）率和总生存（OS）率。统计学分析Fpn表达水平与研究组BCP-ALL患儿的临床特征、免疫表型、ALL相关融合基因、早期治疗反应、临床危险度及其预后的关系。本研究遵循的程序符合四川大学华西第二医院人体试验委员会制定的伦理学标准,得到该委员会批准。结果 1研究组与对照组受试者,以及Fpn高、低表达亚组患儿的性别构成比和年龄分布分别比较,差异均无统计学差异（P〉0.05）。2研究组Fpn中位相对表达量（0.18）显著低于对照组（2.19）,差异有统计学意义（U=1 415.0,P〈0.001）。3研究组患儿初诊时白细胞计数〈50×109/L（47例）和白细胞计数≥50×109/L（17例）患儿的Fpn中位相对表达量分别为0.23和0.04,二者比较,差异亦有统计学意义（U=399.0,P=0.02）。分别按照初诊时中位白细胞计数（21.1×109/L）和中位初诊幼稚细胞绝对计数（14.1×109/L）进行划分,研究组初诊时高、低中位白细胞计数和�Objective To study the expression levels of ferroportin （Fpn） in lymphoblastic leukemia cells in children with precursor B-cell acute lymphoblastic leukemia （BCP-ALL）, and to explore the possible correlations with various clinical features and treatment outcomes. Methods Sixty-four children with newly diagnosed BCP-ALL in West China Second Hospital from February 2011 to June 2014 were enrolled into this study as study group, and were risk-stratified and treated according to the Chinese Children Leukemia Group ALL 2008 （CCLG-ALL 2008） protocol. Twenty-one healthy children for health check-up in our hospital during the same period were chosen by random number table as control group. Levels of Fpn relative media expression levels in bone marrow and peripheral mononuclear cells isolated from leukemic and control group children were determined respectively by fluorescence real-time reverse transcription polymerase chain reaction （RT-PCR）. Level of Fpn relative media expression 0.18 was set as the threshold of Fpn relative media expression levels, patients with level of Fpn relative expression ~ 0. 18 in study group were enrolled into Fpn high expression levels subgroup （n：32）, while patients with level of Fpn relative expression 40. 18 in study group were enrolled into Fpn low expression levels subgroup （n= 32）. Prognosis in terms of relapse-free survival （RFS） rate, event-free survival （EFS） rate and overall survival （OS） rate were calculated by Kaplan-Meier method. Correlations between relative median Fpn expression levels and various clinical features, immunophenotype, ALL related fused gene, early treatment response, clinical risk degree and prognosis were analyzed by statistical methods. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of West China Second University Hospital, Sichuan University. Results （~）There were no statistical differences among the gender ratio and age distribution between study group and control group, Fpn

关 键 词：急性B前体淋巴细胞白血病 铁转出蛋白 危险因素 预后 儿童 

分 类 号：R733.71[医药卫生—肿瘤]