急性白血病儿童黑色素瘤特异性抗原基因表达的意义

Expression and Clinical Implications of Preferentially Expressed Antigen of Melanoma Gene in Children with Acute Leukemia

目的检测黑色素瘤特异性抗原(PRAME)基因在急性白血病儿童中的表达,并探讨其临床意义。方法用半定量逆转录聚合酶链反应(RT-PCR)检测72例急性白血病(AL)患儿及20例对照者骨髓或外周血中PRAME基因mRNA的表达,并对PRAME基因mRNA表达阳性者进行动态检测。结果急性白血病患儿确诊时PRAME基因的阳性表达率为40.28%,其中45例急性淋巴细胞白血病患儿阳性表达率为40.0%,27例急性髓细胞白血病患儿中PRAME基因的阳性表达率为40.74%,两者之间无显著差异(P>0.05);而对照组均为阴性表达。PRAME基因的表达在白血病缓解期明显降低,当病情复发时PRAME基因的表达再次上升。结论PRAME基因在儿童AL中有较高水平表达,其动态变化与预后密切相关,可作为儿童AL微小残留病变的一个监测指标,对判断预后、指导治疗有重要意义。

Objective To investigate the expression and clinical implications of preferentially expressed antigen of melanoma（PRAME） gene in children with acute leukemaia. Methods Relative quantitative reverse transcriptase polymerase chain reaction was used to measure the expression of PRAME gene of bone marrow or blood in 72 children with acute leukemia and 20 controls. And the children with positive expression of PRAME gene was studied dynamically. Results The positive expression of PRAME gene was found in 40.28 % cases on diagnosis. PRAME gene expression in 40.0% of 45 acute lympholdastic leukemia （ALL） patients was found , and 40.74% in 27 acute myelocytic leukemia（AML） ones. There was no significant difference between ALL and AML （ P 〉 0.05）, but the expression in controls were negative. The expression levels of PRAME gone at remission was decreased obviously, but increased again when the patients relapsed. Conclusions Expression of PRAME gene has a high level in childhood acute leukemia. The dynamic changes are closely related with the prognosis. It can he regarded as a candidate for detecting minimal residual disease in acute leukemia, and may have important implications for estimating the prognosis and guiding the chemical therapy.