儿童急性B淋巴细胞白血病致癌基因FGFR3表达对预后的影响研究  

Expression of FGFR3 gene in childhood acute B lymphoblastic leukemia and its relation to disease progression

作　　者：吴静怡[1] 周剑峰[2] 裴仁治[1] 张丕胜[1] 刘旭辉[1] 杜小红[1] WU Jingyi;ZHOU Jianfeng;PEI Renzhi;ZHANG Pisheng;LIU Xuhui;DU Xiaohong(Department of Hematology,Yinzhou Hospital ,Medical College of Ninbo University,Ninbo 315000,China)

机构地区：[1]宁波大学医学院附属鄞州医院血液内科,315000 [2]华中科技大学同济医学院附属同济医院血液科

出　　处：《浙江医学》2017年第2期89-92,101,共5页Zhejiang Medical Journal

基　　金：浙江省自然科学基金资助项目(LQ12H08001);浙江省医药卫生科技项目(2012KYB186);宁波市自然科学基金项目(2012A610236);宁波市医学科技计划项目(2011B23)

摘　　要：目的分析急性B淋巴细胞白血病(B-ALL)患儿成纤维细胞生长因子受体3(FGFR3)基因的表达情况,探讨其在疾病预后判断中的意义。方法采用实时定量PCR法检测52例B-ALL患儿(B-ALL组)与12例对照儿童(对照组)骨髓血中B淋巴细胞FGFR3基因表达水平;并以B-ALL组患儿FGFR3基因表达水平的中位数为界,将B-ALL组患儿分为FGFR3基因高表达组和FGFR3基因低表达组。比较FGFR3基因高表达组和FGFR3基因低表达组患儿的各项临床指标;随访36个月,比较两组患儿的无事件生存(EFS)率。采用流式细胞术检测B淋巴细胞免疫分型、巢式PCR法检测B淋巴细胞融合基因,比较不同B淋巴细胞免疫分型及融合基因的B-ALL组患儿FGFR3基因表达水平。结果 B-ALL组患儿FGFR3基因表达水平高于对照组儿童(1.637±0.903 vs0.645±0.559,P<0.05)。FGFR3基因高表达组与FGFR3基因低表达组患儿性别、年龄、外周血WBC、肝脾有无肿大、有无髓外浸润、B淋巴细胞免疫分型及染色体核型等临床指标比较均无统计学差异(均P>0.05)。FGFR3基因高表达组患儿EFS率低于FGFR3基因低表达组患儿(49.97%vs 76.17%,P<0.05)。B-ALL组患儿中,CD34^+患儿FGFR3基因表达水平高于CD34^-患儿(P<0.05),BCR/ABL^+患儿FGFR3基因表达水平高于BCR/ABL^-患儿(P<0.05)。结论 FGFR3基因高表达与肿瘤发生、发展有关,有望成为辅助评价儿童B-ALL预后的指标。Objective To investigate the expression of fibroblast growth factor receptors3(FGFR3)gene in childhoodacute B lymphoblastic leukemia(B-ALL),and its clinical significance in disease progression.Methods The expression levels ofFGFR3in52children with B-ALL and12normal children were assayed by real time RT-PCR.Clinical indicators were comparedbetween patients with high FGFR3expression and those with low FGFR3expression.Patients were followed up for36months.The event-free survival(EFS)rate was compared with single factor analysis between two groups.B lymphocyte immuneclassification was detected by flow cytometry and B lymphocyte fusion gene was detected by nested PCR.The expression levelsof FGFR3were compared among different immune classification and fusion gene groups.Results FGFR3was over-expressedin children with B-ALL compared with normal controls(1.637±0.903vs0.645±0.559,P<0.05).There were no significantdifferences in sex,age,peripheral blood WBC count,hepatosplenomegaly,extramedullary infiltration,B lymphocyte immuneclassification and karyotype between low FGFR3group and high FGFR3group(P>0.05).The probability of3-year EFS forpatients with high FGFR3level was significantly lower than that with low FGFR3level(49.97%vs76.17%,P<0.05).Expressionlevels of FGFR3were significantly different between BCR/ABL+group and BCR/ABL-group(P<0.05)and between CD34+groupand CD34-group(P<0.05).Conclusion Over-expression of FGFR3may participate in malignant hematopoiesis and thedetection of FGGR3expression might be helpful in evaluation of disease progression in childhood acute B lymphoblastic leukemia.

关 键 词：急性B淋巴细胞白血病 FGFR3 预后 

分 类 号：R733.71[医药卫生—肿瘤]