EZH2在AML1/ETO阳性急性髓系白血病中的表达及临床意义  

The expression and clinical significance of EZH2 in AML1/ETO-positive acute myeloid leukemia

作　　者：陈荣华[1] 王艳梅[1] 石瑞平[1] CHEN Ronghua;WANG Yanmei;SHI Ruiping(Department of Hematology,Zhengzhou People's Hospital,Zhengzhou 450002,China)

机构地区：[1]郑州人民医院血液内科,河南郑州450002

出　　处：《山东第一医科大学（山东省医学科学院）学报》2022年第5期360-364,共5页Journal of Shandong First Medical University ＆ Shandong Academy of Medical Sciences

摘　　要：目的探讨果蝇zeste基因增强子人类同源物2(enhancer of zeste homolog 2,EZH2)在AML1/ETO融合基因(AML1/ETO)阳性急性髓系白血病(acute myelogenous leukemia,AML)中的表达及临床意义。方法选取2015年1月至2018年1月郑州人民医院血液内科收治的AML1/ETO阳性AML患者40例作为AML1/ETO阳性组,另选取同期AML1/ETO阴性AML患者40例作为对照组。采用实时荧光定量聚合酶链反应(fluorescence quantitive polymerase chain reaction,FQ-PCR)检测骨髓单个核细胞(bone marrow mononuclear cells,BM-MNCs)中EZH2 mRNA的表达水平。随访3年,采用Kaplan-Meier法分析EZH2 mRNA表达水平与AML1/ETO阳性AML患者预后的关系,采用Cox回归分析影响AML1/ETO阳性AML患者无复发生存和总生存的危险因素。结果AML1/ETO阳性组患者BM-MNCs中EZH2 mRNA表达水平高于对照组,差异有统计学意义(P<0.05)。AML1/ETO阳性AML患者BM-MNCs中EZH2 mRNA表达水平与白细胞计数、外周血幼稚细胞比例、髓外浸润、染色体核型预后分层及首次诱导治疗后疗效有关,且与白细胞计数、外周血幼稚细胞比例均呈正相关,差异均有统计学意义(P<0.05)。Kaplan-Meier曲线显示,EZH2 mRNA低表达组3年总生存率明显高于EZH2 mRNA高表达组(P<0.05)。Cox回归分析显示,首次诱导治疗后疗效及EZH2 mRNA表达情况是影响AML1/ETO阳性AML患者无复发生存和总生存的独立危险因素(P<0.05)。结论AML1/ETO阳性AML患者EZH2 mRNA高表达,可作为评估患者预后的生物标志物。Objective:To investigate the expression and clinical significance of enhancer of zeste homolog 2(EZH2)in AML1/ETO fusion gene(AML1/ETO)-positive acute myeloid leukemia(AML).Methods:From January 2015 to January 2018,40 AML1/ETO-positive AML patients admitted to the Department of Hematology in our hospital were selected as the AML1/ETO-positive group.In addition,40 AML1/ETO-negative AML patients during the same period were selected as the control group.Real-time fluorescence quantitative PCR was used to detect the expression level of EZH2 mRNA in bone marrow mononuclear cells(BM-MNCs).After 3 years of follow-up,the Kaplan-Meier method was used to analyze the relationship between EZH2 mRNA expression and the prognosis of AML1/ETO-positive AML patients,and Cox regression analysis was used to analyze the risk factors that affected the relapse-free survival and overall survival of AML1/ETO-positive AML patients.Results:The expression level of EZH2 mRNA in BM-MNCs in the AML1/ETO positive group was significantly higher than that in the control group(P<0.05).The expression level of EZH2 mRNA in BM-MNCs of AML1/ETO-positive AML patients was related to white blood cell count,proportion of peripheral blood immature cells,extramedullary infiltration,prognosis of karyotype,and efficacy of first induction therapy(P<0.05),and was positively correlated with the white blood cell count and the proportion of immature cells in peripheral blood(P<0.05).The Kaplan-Meier curve showed that the 3-year overall survival rate of the EZH2 mRNA low expression group was significantly higher than that of the EZH2 mRNA high expression group(P<0.05).Cox regression analysis showed that the efficacy of the first induction treatment and EZH2 mRNA expression were independent risk factors that affected the relapse-free survival and overall survival of AML1/ETO-positive AML patients(P<0.05).Conclusion:The expression of EZH2 mRNA is high in AML patients with positive AML1/ETO, which can be used as a biomarker to assess the prognosis of patients.

关 键 词：急性髓系白血病 AML1/ETO融合基因 果蝇zeste基因增强子人类同源物2 预后 

分 类 号：R733.71[医药卫生—肿瘤]