AML和ALL患者骨髓EVI1表达水平及其与白血病分型、临床特征和预后的相关性分析  

Expression of EVI1 in Bone Marrow of Patients with AML and ALL and Its Correlation with Leukemia Subtyping,Clinical Features and Prognosis of Patients

作　　者：彭定辉[1] 刘静 胡汉宁[1] PENG Ding-Hui;LIU Jing;HU Han-Ning(Department of Laboratorial Medicine,Zhongnan Hospital of Wuhan Unirersity;Department of Hematology and Parthology,Wuhan Kangshengda Institute of Laboratorial Medicine,WuUan 430071,Hebei Province,China)

机构地区：[1]武汉大学中南医院检验科 [2]武汉康圣达医学检验所血液病理科,湖北武汉430071

出　　处：《中国实验血液学杂志》2018年第5期1323-1329,共7页Journal of Experimental Hematology

基　　金：湖北省卫计委联合基金临床研发项目(WJ2018H0011)

摘　　要：目的:探讨白血病患者骨髓中的EVI1基因在AML和ALL中的表达情况,以及其与白血病分型、患者临床特征以及预后的相关性。方法:选取2012年至2016年间中南医学院收治的白血病患者333例,其中AML患者263例,ALL患者70例,正常对照的志愿者13例。抽取患者及志愿者的骨髓样本,用Ficoll法分离骨髓样本中的单个核细胞,提取总DNA,然后采用实时荧光定量PT-PCR检测法检测EVI1 mRNA的相对表达水平,比较EVI1mRNA在AM L、ALL患者中的表达差异。采用相关的统计学方法分析EVI1表达与白血病分型、患者临床特征以及患者预后之间的相关性。结果:根据实时荧光定量PT-PCR检测的EVI1 mRNA表达结果,EVI1 mRNA在AM L、ALL患者中均有较高的表达水平,因此2组的EVI1 mRNA表达水平比较没有显著的差异(t=1. 756,P>0. 05),但是ALL患者在EVI1 mRNA发生过表达及低表达的表达率高于AM L患者,而正常表达的表达率低于AM L患者,差异存在统计学意义(χ~2=13. 698,P <0. 05)。在AM L-M1中,T-ALL两个亚型中患者的Plt水平与EVI1 mRNA表达水平呈正相关(r=0. 393,P <0. 05;ρ=0. 442,P <0. 05),而在AM L-M3亚型中,患者的Blasts(%)在AML-M3与EVI1 mRNA表达水平有显著的负相关性(r=-0. 518,P <0. 01)。在EVI1 mRNA表达分布上,EVI1 mRNA的表达分布与AML患者年龄存在相关性(χ~2=6. 684,P <0. 05)。AM L患者中有高表达EVI1mRNA的患者的有较差的预后(Log-Rank检验,P <0. 05),且AM L-M3亚型的EVI1 mRNA高表达患者比非高表达的患者有更显著的较差预后(Log-Rank检验,P <0. 01)。结论:在EVI1的表达水平上,AML及ALL患者并没有太大的差异,但在EVI1的表达分布差异明显,并且其差异与患者的年龄有一定的相关性。同时患者的一些临床特征以及急性白血病的部分亚型均与EVI1的表达水平存在一定相关性。Objective:To explore the expression of EVU gene in AML and the ALL patients'bone marow cells,and its correlation with the leukemic typing,clinical characteristics and prognosis.Methods:Three hundred and thirty-three cases of leukemia in our hospital from 2012 to 2016 were enrolled in this study.Among them there were 263 cases of AML,70 cases of ALL,and 13 volunteers were selected as normal controls.The bone marow samples of the patients and volunteers were aspirated.Firstly,the blood mononuclear cells(PBMNC)were separated from the samples through the Ficoll-Hypaque density gradient centrifugation.Secondly,the total DNA was extracted,and the expression of EWi mRNA were assayed by real-time quantitative PCR,which help to find out the EWi mRNA expression difference between AML and ALL.Finally,the correlation of EWi expression with the acute leukemia typing,clinical characteristics and prognosis were analyzed by a series of statistical method.Results:Based on the expression levels of the EWU mRNA determined by real-time quantitative PCR,the expression levels in AML and ALL were both higher,but without significant difference.The rates of both EWU mRNA over expression and low expression of the EVU mRNA in AML patients were higher than those in AML group,however,the rate of normal expression in ALL group was statistically significantly lower than that in the AML.The level of Pit in patients with AML-M1 and T-ALL positively correlated with the level of EVI1 expression(r=0.393,.P<0.05;=0.442,P<0.05)while the level of blasts(%)in patients with AML-M3 negatively correlated with the level of EVU expression.The expression of EVU correlated with the age of patientsQ2=2.614,P<0.05).The prognosis of AML patients with high expression of EVU mRNA was poor(Log-Rank test,P<0.05)and AML-M3 patients with high expression of EVU had a significantly poorer prognosis than that of patients without high expression(Log-Rank test,P<0.01).Conclusion:In expression level of EVU no difference has been found in AML and ALL,but the distribution of

关 键 词：急性白血病 EVI1基因 急性髓系白血病 急性淋巴细胞白血病 临床特征 

分 类 号：R733.71[医药卫生—肿瘤]