急性髓系白血病患者谷胱甘肽过氧化物酶3的表达及临床意义  

Clinical significance of GPX3 expression in acute myeloid leukemia

作　　者：周静东[1] 杨磊[1] 杨静[1] 张盈盈[1] 朱晓雯[1] 钱军[1] 

机构地区：[1]江苏大学附属人民医院血液科,江苏镇江212002

出　　处：《江苏大学学报（医学版）》2015年第5期425-430,共6页Journal of Jiangsu University：Medicine Edition

基　　金：国家自然科学基金资助项目(81270630;81172592);江苏省临床医学科技专项基金资助项目(BL2012056);江苏省"333工程"资助项目(BRA2013136);镇江市医学重点人才;镇江市社会发展项目(SH2013042;SH2013082;SH2014044)

摘　　要：目的:检测急性髓系白血病(acute myeloid leukemia,AML)患者谷胱甘肽过氧化物酶3(glutathione peroxidase 3,GPX3)的表达水平并分析其临床意义。方法:应用实时定量PCR方法检测103例初诊AML患者和32例健康供髓者的骨髓单个核细胞中GPX3的mRNA水平,并根据其水平分为高低表达组,比较两组间临床参数的异同,分析其临床意义。结果:AML患者中GPX3的表达水平与对照组相比显著下调(U=630.000,P<0.001)。ROC曲线分析表明,ROC曲线下面积0.809(95%CI:0.738~0.879,P<0.001)及0.824(95%CI:0.728~0.920,P<0.001)可有效区分对照组与AML患者及正常核型AML(cytogenetically normal AML,CN-AML)患者。GPX3低表达组患者血小板计数明显高于GPX3高表达组患者(U=815.500,P=0.011)。GPX3低表达的频率在核型良好/中等组(63.7%,58/91)高于核型不良组(25.0%,2/8),差异接近有统计学意义(P=0.054)。GPX3高低表达组间,全部AML、Non-M3及CNAML患者的完全缓解率与总体生存无统计学差异(P>0.05)。结论:GPX3低表达是AML患者的常见分子事件,但对患者的预后无影响。Objective:To investigate the expression of GPX3 (glutathione peroxidase 3)in acute mye-loid leukemia (AML)and analyze its clinical significance.Methods:Real-time quantitative PCR was per-formed to detect GPX3 mRNA level in the bone marrow mononuclear cells from 103 de novo AML patients and 32 controls.Clinical significance of GPX3 expression in AML patients was analyzed by comparing the differences of clinical parameters in the groups (high GPX3 expression and low GPX3 expression)divided according to GPX3 mRNA level.Results:GPX3 expression in AML patients was significantly decreased compared to controls(U =630.000,P <0.001 ).Receiver operating characteristic curve (ROC)analysis revealed that areas under the ROC curve of 0.809 (95%CI:0.738 -0.879,P <0.001)or 0.824 (95%CI:0.728 -0.920,P <0.001)could distinguish AML patients or cytogenetically normal AML(CN-AML) patients from controls,respectively.GPX3 low-expressed patients showed a significantly higher platelets than high-expressed patients (U =815.500,P =0.011).The frequency of GPX3 low expression in favora-ble /intermediate karyotypes (63.7%,58 /91 )was higher than in poor karyotype (25.0%,2 /8,P =0.054).No significant differences were found in complete remission and overall survival between high and low GPX3 expression groups among whole AML,Non-M3,and CN-AML patients (P >0.05).Conclu-sion:Low GPX3 expression is a common event in de novo AML patients,but has no effect on the prognosis of de novo AML patients.

关 键 词：谷胱甘肽过氧化物酶3 急性髓系白血病 表达 

分 类 号：R733.71[医药卫生—肿瘤]