亚砷酸诱导分化的急性早幼粒细胞白血病细胞浸润人脑膜组织的体外模拟及其分子机制研究

目的:探讨急性早幼粒细胞白血病(Acute promyelocytic leukemia,APL)合并中枢神经系统白血病的发病机制。方法:采用流式细胞术检测亚砷酸(Arsenious acid, ATO)诱导分化前后的APL细胞及人APL细胞株NB4细胞表面CD56、CXCR4的表达;用荧光染料-羧基荧光素二醋酸盐琥珀酰亚胺酯标记ATO分化的APL(APL/ATO)、NB4细胞(NB4/ATO);用微重力旋转培养法体外模拟APL细胞浸润人脑膜组织,观察组织学及超微结构。结果:ATO诱导后,APL/ATO细胞表面CXCR4的表达明显高于诱导前(35.2±9.5%vs. 18.6±4.9%);NB4/ATO细胞表面CXCR4的表达明显高于诱导前(39.6±2.6%vs. 21.0±7.3%);APL/ATO细胞表面CD56的表达明显高于诱导前(36.6±8.9%vs. 25.8±5.15%);NB4/ATO细胞表面CD56的表达明显高于诱导前(44.6±8.4%vs. 25.6±2.4%)。组织学实验结果显示对照组脑膜组织未见NB4、APL细胞浸润,实验组可见APL/ATO、NB4/ATO细胞浸润到人脑膜组织中;荧光显微镜下可见被标记的APL/ATO、NB4/ATO细胞浸润到人脑膜组织中,扫描电镜见APL/ATO、NB4/ATO细胞浸润到脑膜组织中。结论:本研究采用微重力旋转培养系统体外模拟了ATO诱导分化的异常早幼粒细胞浸润人脑膜组织,APL细胞和NB4细胞CXCR4、CD56的表达升高可能是ATO诱导治疗APL所致的中枢神经系统浸润的分子机制之一。     

免疫相关基因FGF13、GZMB、FLT3、CRLF3可能与急性髓系白血病患者预后密切相关

为了构建急性髓系白血病（AML）患者的预后风险模型,本研究通过IMMPORT数据库提取免疫基因,通过基因表达综合（GEO）数据库和AML相关转录组RNA测序数据集筛选差异表达的免疫基因,基于癌症基因组图谱（TCGA）数据库下载AML相关的表达谱数据集（TCGA-LAML）及临床数据,对差异表达的免疫基因进一步进行单因素COX回归分析和多因素COX回归分析,最终确定了关键免疫基因,随后根据免疫基因进行单基因预后分析以及免疫浸润分析。结果显示：与正常对照组相比,在AML患者的骨髓样本中,有55个免疫基因显著上调或下调,其中由4个免疫基因（FGF13、GZMB、FLT3、CRLF3）构建的风险模型能预测AML患者的预后[曲线下面积（AUC）=0.741];高风险组和低风险组之间免疫细胞的含量存在显著差异,其中FGF13、CRLF3为低风险基因,GZMB、FLT3为高风险基因。这为4个免疫基因FGF13、GZMB、FLT3、CRLF3及其构建的风险模型用于监测AML患者的预后和免疫浸润情况提供了理论基础。     

CD56和CD117浆细胞免疫表型与多发性骨髓瘤患者染色体核型和预后的研究

目的:探讨CD56和CD117浆细胞免疫表型与多发性骨髓瘤患者染色体核型和预后的关系。方法:选取2011年1月至2017年3月我院收治的66例多发性骨髓瘤患者,均采用以硼替佐米为基础的VTD化疗方法。采集患者新鲜骨髓液,采用流式细胞术(FCM)和荧光原位杂交技术(FISH)检测浆细胞免疫表型和细胞染色体核型。分析浆细胞免疫表型与患者染色体核型和预后的关系。结果:66例患者浆细胞CD19+、CD20+、CD45+、CD56+、CD117+表达频率分别为7.6%(5/66)、18.2%(12/66)、45.5%(30/66)、66.7%(44/66)和40.9%(27/66)。20例行FISH检测的患者,18例(90.0%)核型异常,其中12例(66.7%)IgH重排,9例(50.0%)1q21+扩增,8例(44.4%)del(13q14.3)缺失,10例(55.6%)del(13q14)缺失,3例(16.7%)del(17p)缺失。CD56+患者1q21+扩增和del(13q14.3)发生率显著低于CD56-患者(27.3%vs 85.7%,18.2%vs 85.7%,P0.05)。CD117+患者1q21+扩增和del(17p)发生率显著低于CD117-患者(12.5%vs 80.0%,12.5%vs 20.0%,P0.05)。CD56+患者的PFS和OS明显延长[23.4(2.0-91.4)月vs 19.8(3.0-85.1)月,34.5(8.9-96.5)月vs 30.1(6.7-84.3)月,P0.05]。CD117+患者PFS和OS明显延长[22.9(1.0-94.3)月vs 20.3(2.0-84.3)月,33.9(7.4-93.5)月vs 31.4(6.7-89.7)月,P0.05]。Kaplan-Meier分析CD56和CD117阳性与阴性患者的PFS曲线和OS曲线存在显著性差异(P0.05)。结论:CD56+和CD117+患者的预后明显优于CD56-和CD117-患者,CD56-和CD117-患者染色体异常核型的发生率明显增加。     

儿童急性淋巴细胞白血病对预后的影响分析

目的:探讨儿童急性淋巴细胞白血病分型对预后的影响,为临床治疗提供依据.方法:回顾性分析2007年1月～2008年12月我院收治的急性淋巴细胞白血病患儿32例,比较不同分型的预后情况.结果:ALL-L1、ALL-L2与ALL-L3的首次诱导CR率(X2=1.087,P＞0.05)、完全CR率(X2=0.607,P＞0.05),差异无统计学意义;CR的治疗时间(t=6.001,P＜0.05)、3年生存率(X2=9.458,P＜0.05),差异有统计学意义.T-ALL、B-ALL的首次诱导CR率(X2=8.891,P＜0.05)、达到CR治疗时间(t=6.361,P＜0.05)、完全CR率(X2=11.892,P＜0.05),差异有统计学意义.两型的3年生存率(X2=1.536,P＞0.05),差异有统计学意义.B-ALL中各型别首次诱导CR率(X2=0.494,P＞0.05)和完全CR率(X2=0.405,P＞0.05),差异统计学意义.B-ALL中各型别达到CR的治疗时间(t=7.007,P＜0.05)和3年生存率(X2=6.609,P＜0.05),差异有统计学意义.结论:儿童急性白血病其预后与其分型有一定的相关性,因此临床治疗应结合患儿的分型进行个体化治疗.     

急性髓系白血病患者HtrA2基因、Set基因表达与疗效和预后的关系研究

摘要 目的：探讨急性髓系白血病（AML）患者HtrA2基因、Set基因表达与疗效和预后的关系。方法：选择2017年6月~2019年6月来我院进行治疗的90例病历资料完整的初诊为AML患者作为本次研究对象,作为AML组,另选取同时期来我院进行健康体检的90例志愿者作为对照组。检测HtrA2基因、Set基因在两组受试者外周血中的表达;分析HtrA2基因、Set基因的表达与AML患者年龄、性别、白细胞计数、NCCN预后分型和疗效的关系。结果：HtrA2基因在AML组中表达水平低于对照组,Set基因在AML组中表达水平高于对照组（P<0.05）。HtrA2基因的表达和年龄、性别、白细胞计数无关（P>0.05）;Set基因的表达和年龄、性别无关（P>0.05）,与白细胞计数有关（P<0.05）。HtrA2基因在NCCN不同的预后分组中的表达差异无统计学意义（P>0.05）;Set基因在NCCN不同的预后分组中的表达差异有统计学意义（P<0.05）。HtrA2基因和Set基因在不同疗效患者中的表达差异有统计学意义（P<0.05）。结论：AML患者HtrA2基因表达下降,Set基因表达升高,Set基因和HtrA2基因具有评估AML疗效的潜力,Set基因可辅助评估AML患者的预后。     

RNAi干预急性髓系白血病对p38信号通路的影响

目的 探讨RNAi技术治疗急性髓系白血病（acute myeloid leukemia,AML）对p38信号通路的影响。方法 以NC（HL-60细胞）和HK（含siRNA-FLT3的阴性对照的HL-60细胞）、F1（实验组,含siRNA-FLT3的HL-60细胞,本实验室已实验证明对FLT3有干扰作用）三种细胞株为研究对象,分为药物组（信号通道抑制作用组）和对照组（未加信号通道抑制剂）。通过RT-PCR和Western blot检测对照组和药物组p38 mRNA水平和蛋白表达的变化,MTT和FCM分别测定细胞活性和细胞凋亡率的变化。结果 药物组、对照组组内比较：以NC做参照,F1能诱导p38 mRNA水平和蛋白表达下降、从而抑制细胞的增殖,促进细胞凋亡,差异有统计学意义（均P 0.05）;与对照组相比,药物组p38 mRNA水平和蛋白表达下降,细胞活性下降,细胞凋亡率增加,差异有统计学意义（均P<0.05）;药物组的F1与药物组的NC、药物组的F1与对照组的F1分别比较,差异有统计学意义（均P s<0.05）。结论 p38信号通路是RNAi技术干扰HL-60细胞FLT3基因表达引起细胞凋亡的途径之一,SB203580（P38 MAPK抑制剂）对其有协同增效作用。     

PLZF基因大致结构的研究

报道了与急性早幼粒细胞白血病(APL)t(11;17)变异型易位有关的PLZF基因结构及表达.该基因至少长130kb,由7个外显子和6个内含子组成.发现外显子2中存在着替换剪接现象,且剪接供体信号为不典型的GA.PLZF基因的断裂点主要丛集于内含子3,该基因的表达具有组织特异性.     

急性髓性白血病预后免疫相关基因的生物信息学分析

急性髓性白血病(acute myeloid leukemia,AML)是一种造血干细胞的恶性克隆性疾病,复发率高,预后差,临床缺乏准确而稳健的预后标志物.本研究旨在构建一个免疫相关基因(immune-related genes,IRGs)的拟合模型来预测AML患者的预后.首先,从TCGA中下载AML样本的基因表达谱数据...     

CD47 在急性白血病干细胞中的表达及其对临床疗效及预后的影响

目的:探讨CD47在急性白血病患者骨髓白血病细胞的表达及其临床意义。方法:选择2013年5月-2015年5月在我院确诊的急性白血病患者101例作为研究对象,其中急性淋巴细胞白血病50例(ALL组),急性髓系白血病51例(AML组)。另选取同期在我院接受体检的健康志愿者39例作为对照组。采用流式细胞仪检测白血病细胞表面CD47的表达情况,并分析CD47表达与急性白血病患者临床疗效及复发情况的关系。结果:急性白血病患者白血病细胞CD47的阳性表达率明显高于健康对照组,差异具有统计学意义(P0.05);而ALL组与AML组患者白血病细胞CD47的阳性表达率比较差异无统计学意义(P0.05);CD47阴性表达的急性白血病患者CR率显著高于阳性表达者,差异具有统计学意义(P0.05);ALL组和AML组CD47阴性表达患者CR率显著高于CD47阳性表达患者,差异具有统计学意义(P0.05),但两组之间比较,差异无统计学意义(P0.05);CD47阳性表达的急性白血病患者复发率显著高于阴性表达患者,差异具有统计学意义(P0.05);ALL组和AML组CD47表达阳性患者复发率明显高于阴性患者,差异具有统计学意义(P0.05),但两组之间比较差异无统计学意义(P0.05)。结论:急性白血病患者白血病细胞表面CD47的表达异常升高,且与白血病患者的疗效和预后有关,CD47可能作为一种急性白血病的诊断及疗效和预后的辅助评估指标。     

急性早幼粒细胞白血病维甲酸耐药性的双向电泳分析

目的:研究急性早幼粒细胞白血病(APL)对全反式维甲酸(ATRA)治疗敏感和耐药患者的外周血淋巴细胞在蛋白质组水平上的差异。方法:采用双向凝胶电泳(2-DE)对敏感和耐药患者的外周血淋巴细胞进行蛋白质组差异分析。结果:ATRA敏感和耐药患者外周血淋巴细胞的2-DE平均蛋白质点分别为(746±57)和(617±41),敏感与耐药患者的2-DE相比,有16个蛋白点表达明显上调,22个明显下调。另有4个蛋白点(Mr/pI:24.6kD/8.05,32.3kD/5.17,22.3kD/6.51,25.1kD/7.09)在敏感患者中特异表达,5个蛋白点(Mr/pI:21.9kD/5.45,23.4kD/6.27,22.9kD/6.65,23.9kD/7.39,24.7kD/7.65)在耐药患者中特异表达。结论:结果提示这些差异表达的蛋白质可能与APL对ATRA耐药的机制有关,该研究有助于揭示APL对ATRA耐药机理和发现新的临床分子标志物。     

Synthetic strategy for increasing solubility of potential FLT3 inhibitor thieno[2,3-d]pyrimidine derivatives through structural modifications at the C2 and C6 positions

Acute myeloid leukemia (AML) is a clonal disorder of hematopoietic progenitor cell. In AML, a mutation in FLT3 is commonly occurs and is associated with poor prognosis. We have previously reported that thieno[2,3-d]pyrimidine derivative compound 1 exhibited better antiproliferative activity against MV4-11 cells which harbor mutant FLT3 than AC220, which is a well-known FLT3 inhibitor, and has good microsomal stability. However, compound 1 had poor solubility. We then carried out further structural modification at the C₂ and the C₆ positions of thieno[2,3-d]pyrimidine scaffold. Compound 13b, which possesses a thiazole moiety at the C₂ position, exhibited better antiproliferative activity than compound 1 and showed increased solubility and moderate microsomal stability. These results indicate that compound 13b could be a promising potential FLT inhibitor for AML chemotherapy.     

成人和儿童急性早幼粒细胞白血病患者应用三氧化二砷的对比研究

目的:探讨持续慢点三氧化二砷(As2O3)治疗儿童和成人急性早幼粒细胞白血病(APL)患者的疗效。方法:选取2007-2011年来我院就诊并采取持续慢点As2O3方式治疗的APL患者60例,其中儿童28例,成人32例。成人As2O3剂量为0.16 mg/kg,儿童为0.08 mg/kg,每分钟8滴,18-21 h完成,28天为一疗程。测量两组不同时间点的血总砷及血三价砷浓度,并记录治疗过程中高白细胞血症的发生率及高白细胞血症持续时间。结果:儿童中高白细胞血症的发生率为60.71%(17/28),明显高于成人的34.38%(11/32),差异有统计学意义(P0.05)。成人高白细胞血症平均持续时间为7.4天(6-10天),明显高于儿童的5.53天(4-8天),差异有统计学意义(P0.01)。成人不同时间点血总砷浓度高于儿童(P0.01),同一时间点血三价砷浓度高于儿童;随着用药时间延长,成人和儿童血总砷浓度和三价砷浓度增加,差异有统计学意义(均P0.01),于用药第14天达稳态。结论:儿童高白细胞血症发生率高于成人,持续时间短,血总砷及三价砷浓度水平低于成人。     

急性早幼粒细胞白血病（APL）中t（15;17）染色体易位的分子机制研究

对急性早幼粒细胞白血病中ｔ（１５;１７）染色体易位的分子生物学研究显示,１７号染色体上的维甲酸受体α（ＲＡＲＡ）基因与１５号染色体上的ＰＭＬ基因并置,并产生ＰＭＬ－ＲＡＲＡ融合基因。我们以前的工作证明ＡＰＬ患者中ＰＭＬ基因断裂点集中于２个限区域,即ＰＭＬ－ｂｃｒ１和ＰＭＬ－ｂｃｒ ２,二者相距约１０ｋｂ。本文确定了ＰＭＬ－ｂｃｒ １的ＤＮＡ顺序,并确定了一例ＡＰＬ患者染色体相互易位接合部的基本结构     

Design,synthesis, and biological evaluation of 4-((6,7-dimethoxyquinoline-4-yl)oxy)aniline derivatives as FLT3 inhibitors for the treatment of acute myeloid leukemia

FMS-like tyrosine kinase 3 (FLT3) was an important therapeutic target in acute myeloid leukemia (AML). We synthesized two series of 4-((6,7-dimethoxyquinoline-4-yl)oxy)aniline derivatives possessing the semicarbazide moiety and 2,2,2-trifluoro-N,N′-dimethylacetamide moiety as the linker. The cell proliferation assay in vitro against HL-60 and MV4-11 cell lines demonstrated that most series I compounds containing semicarbazide moiety had more potent than Cabozantinib. Furthermore, the enzyme assay showed that compound 12c and 12g were potent FLT3 inhibitors with IC₅₀ values of 312 nM and 384 nM, respectively. Following that, molecular docking analysis was also performed to determine possible binding mode between FLT3 and the target compound.     

Discovery of quinolinone derivatives as potent FLT3 inhibitors

Recently some fms-like tyrosine kinase 3 (FLT3) inhibitors have shown good efficacy in acute myeloid leukemia (AML) patients. In an effort to develop anti-leukemic drugs, we investigated quinolinone derivatives as novel FLT3 inhibitors. Two substituted quinolinones, KR65367 and KR65370 were subjected to FLT3 kinase activity assay and showed potent inhibition against FLT3 kinase activity in vitro, with IC₅₀ of 2.7 and 0.57 nM, respectively. As a measure of selectivity, effects on the activity of other kinases were also tested. Both compounds have negligible activity against Met, Ron, epidermal growth factor receptor, Aurora A, Janus kinase 2, and insulin receptor; with IC₅₀ greater than 10 μM. KR compounds showed strong growth inhibition in MV4;11 AML cells and increased the apoptotic cell death in flow cytometric analyses. A decrease in STAT5 phosphorylation by KR compounds was observed in MV4;11 cells. Furthermore, in vitro evaluation of compounds structurally related to KR65367 and KR65370 showed a good structure-activity relationship.     

Soluble Fas/Apo-1 (CD95) levels during T cell activation in the presence of acute myelogenous leukemia accessory cells; contributions from local release and variations in systemic levels

Fas (CD95/Apo-1) exists both in membrane-bound and in biologically active soluble (s) forms. Ligation of membrane-expressed Fas can induce apoptosis, and Fas-mediated signaling seems to be involved in T-cell-induced apoptosis of human acute myelogenous leukemia (AML) blasts. The local release of sFas by AML blasts may then function as a protective mechanism by competing with membrane-bound Fas for binding sites on the common Fas ligand (FasL). sFas was released by AML blasts during in vitro culture, and this release was modulated by several cytokines that can be secreted by activated T cells. Increased levels of sFas could be detected during in vitro activation of T cells in the presence of native AML accessory cells, and this was observed both for (i) mitogenic activation of CD4⁺ and CD8⁺ T cell clones derived from acute leukemia patients with therapy-induced leukopenia and (ii) allostimulated activation of T cells derived from normal donors. However, local in vivo levels of sFas will also be influenced by variations in systemic levels. High serum levels of sFas were detected in acute leukemia patients during chemotherapy-induced cytopenia, but these levels decreased during complicating bacterial infections. In contrast, serum levels of sFasL were normal in leukopenic patients. The present results support the hypothesis that local release of sFas can function as a protective mechanism against AML-reactive T cells, but the effects of this local release are, in addition, modulated by variations in systemic levels of sFas (but not sFasL). Received: 9 March 2000 / Accepted: 25 May 2000     

The mRNA–miRNA–lncRNA Regulatory Network and Factors Associated with Prognosis Prediction of Hepatocellular Carcinoma

The aim of this study was to identify novel prognostic mRNA and microRNA (miRNA) biomarkers for hepatocellular carcinoma (HCC) using methods in systems biology. Differentially expressed mRNAs, miRNAs, and long non-coding RNAs (lncRNAs) were compared between HCC tumor tissues and normal liver tissues in The Cancer Genome Atlas (TCGA) database. Subsequently, a prognosis-associated mRNA co-expression network, an mRNA–miRNA regulatory network, and an mRNA–miRNA–lncRNA regulatory network were constructed to identify prognostic biomarkers for HCC through Cox survival analysis. Seven prognosis-associated mRNA co-expression modules were obtained by analyzing these differentially expressed mRNAs. An expression module including 120 mRNAs was significantly correlated with HCC patient survival. Combined with patient survival data, several mRNAs and miRNAs, including CHST4, SLC22A8, STC2, hsa-miR-326, and hsa-miR-21 were identified from the network to predict HCC patient prognosis. Clinical significance was investigated using tissue microarray analysis of samples from 258 patients with HCC. Functional annotation of hsa-miR-326 and hsa-miR-21-5p indicated specific associations with several cancer-related pathways. The present study provides a bioinformatics method for biomarker screening, leading to the identification of an integrated mRNA–miRNA–lncRNA regulatory network and their co-expression patterns in relation to predicting HCC patient survival.