CD_(40)抗原和生存素基因在急性髓性白血病细胞中表达及其临床意义

Expression of antigen CD_(40)and survivin gene and their clinical implications in acute myeloid leukemia

目的 探讨急性髓性白血病 (AML)细胞的CD40 抗原和抗凋亡基因生存素 (survivin)mRNA表达及其临床意义。方法 应用流式细胞仪和逆转录 PCR方法检测 4 8例初治AML患者细胞的CD40 抗原和抗凋亡基因survivinmRNA表达 ,并结合AML患者临床特征进行分析。结果 (1) 4 8例AML患者中 2 5例 (5 2 1% )表达CD40 抗原 ,35例 (72 9% )表达survivinmRNA。 (2 )CD40 + AML组中脾肿大、血小板减少和高白细胞白血病的发生率明显高于CD40 -AML组 (36 0 %、8 7% ) ,P =0 0 2 5 ;(72 0 %、4 3 5 % ) ,P =0 0 4 5 ;(32 0 %、4 4 % ) ,P =0 0 2 4。 (3)survivinmRNA在CD40 + AML和CD40 -AML两组中表达差异无显著性 (2 0 / 2 5、15 / 2 3) ,P =0 2 5 ,但两组中的survivinmRNA表达均明显高于健康对照组 (2 0 / 2 5、6 / 2 0 ) ,P =0 0 0 1;(15 / 2 3、6 / 2 0 ) ,P =0 0 2 1;4 8例AML患者中CD40 抗原阳性率低于survivinmRNA阳性率 (5 2 1%、72 9% ) ,P =0 0 4 1。 (4 )survivin+ AML化疗完全缓解 (CR)率明显低于survivin-AML(31 4 %、6 9 2 % ) ,P =0 0 18。结论 CD40 抗原表达和AML的临床血液学特征存在一定关系 ;表达抗凋亡基因survivinmRNA是AML患者化疗CR率低的原因之一 ,可能是影响AML患者预后的因素?

Objective To evaluate the expressions of CD 40an tigen and anti-apoptosis gene survivin in acute myeloid leukemia (AML) and thei r clinical significance. Methods By using flow cytometry (FCM) and reverse transcriptase polymerase chain reaction (RT-PCR), CD 40 antigen and anti-apoptosis gene survivin mRNA were studied in 48 AML cases and their association with the clinical features of AML was analysed . Results (1) In the 48 AML cases, positive expression of CD 40a ntigen was found in 25 cases(52.1%)and positive expression of anti-apoptosis gene survivin mRNA in 35 cases(72.9%). (2)The incidence of splenomegaly, th rombocytopenia and hyperleukocytosis in CD 40 + AML cases was significantl y higher than those in CD 40 - AML ones(36.0% vs 8.7%), P=0.025; (72.0% vs 43.5%), P=0.045; (32.0% vs 4.4%), P=0.024. (3) There wa s no difference in the number of the expression of survivin mRNA between CD 40 +AML cases and CD 40 -AML ones(20/25 vs 15/23) P= 0.25, but the expression of survivin mRNA of both the groups was highs than tho se of normal controls(20/25 vs 6/20), P=0.001;(15/23 vs 6/20), P=0.021 . In the 48 AML cases the rate of the expression of CD 40antigen was less than those of anti-apoptosis gene survivin mRNA (52.1% vs 72.9%), P=0.0 41. (4) The complete remission (CR) rate in the survivin+ AML cases receiving chemotherapy was significantly less than that in the survivin- AML ones(31. 4% vs 69.2%), P=0.018. Conclusions The expression of CD 40antigen might be associated with some unfavorable clinical featur es of AML . The expression of anti-apoptosis gene survivin might be one of the reasons that AML have a lower CR rate, and it is one of the prognostic factors in AML.