急性髓系白血病ERG、MDR1及BAALC基因的表达水平及临床意义

目的:探讨急性髓系白血病(acutemyeloidleukemia,AML)患者骨髓单个核细胞的ETS相关基因(ETS related gene,ERG)、多药耐药基因1(Multidrug resistance gene 1,MDR1)、脑和急性白血病胞质(Brain and acute leukemia cytoplasmic,BAALC)基因的表达水平及临床意义。方法:选取90例成人AML患者为研究对象,均接受蒽环类药物诱导化疗联合阿糖胞苷等进行初步治疗,采用实时荧光定量检测PCR技术检测治疗后的骨髓单个核细胞ERG、MDR1、BAALC基因表达,并分析其与患者临床特征、危险度分层、治疗疗效、生存率的关系。结果:AML患者ERG、MDR1、BAALC基因均有强表达,三因子表达强弱同白细胞、血小板等临床指标无明显相关性(P0.05),不同危险度分层对应的ERG、MDR1、BAALC表达之间有明显差异,中危组、高危组患者表达强度均高于低危组(P0.05)。ERG、MDR1低表达组对应的疗效CR(93.1%%,89.6%)、OS(56.5%, 66.7%)较高表达组CR(61.4%, 81.3%)、OS(56.5%,66.7%)值更高(P0.05),不同BAALC表达者疗效CR及生存率OS比较差异无统计学意义(P0.05)。结论:AML患者单个核细胞的ERG、MDR1基因表达水平与其危险度分层、疗效和生存率呈负相关,以REG和MDR1同AML关系敏感,BAALC敏感度较低,联合检测REG、MDR1、BAALC基因表达可能提高AML患者危险度分层、疗效及预后判读的准确度。

Expression Levels of ERG, MDR1 and BAALC genes in Acute Myeloid Leukemia and the Clinical Significances

ABSTRACT Objective: To investigate the expressions and clinical significances of ERG, MDR1 and BAALC genes in the bone marrow mononuclear cells of patients with acute myeloid leukemia(AML). Methods: 90 cases of adult AML were selected as the subjects. All the patients were treated with anthracycline induced chemotherapy combined with ara cytarabine. The expression of ERG, MDR1, BAALC gene in bone marrow mononuclear cells was detected by real-time quantitative fluorescence quantitative PCR technique, and the relationship between the expression of ERG, MDR1, BAALC gene and clinical characteristics, risk stratification, treatment efficacy and survival rate of AML patients were analyzed. Results: The expression of ERG, MDR1 and BAALC genes in AML patients were strongly expressed. There was no significant relationship between the expression of three factor and the clinical index such as white blood cells, platelets, etc(P>0.05). There were significant differences between the expressions of ERG, MDR1 and BAALC(P<0.05) corresponding to the stratification of different risk degrees (P<0.05), the expression of ERG, MDR1 and BAALC in the middle and high group were higher than those of the low group. In relation to the effect of treatment and the survival rate, the CR (93.1%%, 89.6%) and OS (56.5%, 66.7%) of ERG and MDR1 low expression group were higher than those of the higher expression group with CR (61.4%, 81.3%) and OS (56.5%, 66.7%)(P<0.05). There was no difference in the CR and the survival rate of OS with different expression of BAALC(P>0.05). Conclusion: The expressions of REG, MDR1 and BAALC gene in the bone marrow mononuclear cells of AML patients are negatively correlated with the risk degrees, curative effect and survival rate. REG and MDR1 are sensitive to AML, and BAALC is less sensitive. The combined detection of the expression of REG, MDR1, BAALC gene may improve the accuracy of risk stratification, curative effect and prognosis of AML patients.