Survivin基因与早期分化抗原在急性白血病中的表达及其相关性的临床研究

The Clinical studies on the expressions of survivin and early differentiation antigens and their correlation in acute leukemia

目的探讨Survivin基因与CD34、CD90及CD133在急性白血病(AL)中表达、相关性及其与临床预后的关系。方法对68例初发AL患者,20例AL完全缓解患者,10例健康者应用半定量RT-PCR方法检测Survivin基因的表达,及应用流式细胞术(FCM)测定患者白血病细胞膜上CD34、CD90及CD133抗原的表达。结果①AL初发组与CR组患者的Survivin基因表达阳性率均显著高于对照组(P<0.05);②初发组的CD34及CD133表达高于CR组和对照组(P<0.01);③Survivin基因、CD34及CD133表达阳性者临床缓解率明显低于表达阴性者(P<0.05);④CD34/CD133双阳性组完全缓解率显著低于双阴性组(P<0.05);⑤Survivin基因与CD34、CD133的表达均明显相关(P<0.05)。结论①Survivin基因在急性白血病患者呈高表达;②Survivin基因与治疗效果密切相关,可作为急性白血病治疗的一个潜在靶点;③急性白血病细胞CD34及CD133的表达显著高于正常骨髓单个核细胞;④CD34与CD133高表达的白血病患者临床缓解率较低,并且CD34/CD133共同高表达可能是AL的一个不良预后因素;⑤Survivin基因与CD34和CD133的表达明显相关。

Objective To explore the significance of Survivin and early differentiation antigens CD34, CD90 and CD133 expressions and their correlation,and the relationship between them and the clinical prognosis in AL patients. Methods 68 newly diagnosed AL patients,20 AL patients in complete remission and 10 controls were enrolled in this study. The expression of Survivin mRNA in bone marrow cells of all patients was detected with hemi-quantitative reverse transcriptive polymerase chain reaction （RT-PCR） and CD34, CD90, CD133 with flow cytometry . Results①The expression in newly diagnosed group and CR group were significantly higher than that in control group （ P 〈 0. 05 ）. ② The expressions of CD34 and CD133 in newly diagnosed group were significantly higher than that in CR group and control group （P 〈 0.01 ）. ③ The clinical remission rates of patients with positive expressions in Survivin, CD34 and CD133 are much lower than that with negative expressions. ④The clinical remission rates of patients with both positive expressions for CD34 and CD133 are much lower than that with both negative expressions. ⑤Survivin and CD34 or CD133 expression lev- els were positively correlated. Conclusion ①Survivin gene is overexpressed in patients with AL. ②It was significantly associated with the effects of clinical treatment. It could be a potential target for treatment of AL. ③ The expressions of CD34 and CD133 in bone marrow cells of patients with AL was much higher than that in normal bone marrow mononuclear cells. ④The clinical remission rate of patients with positive expressions of CD34 and CD133 is much lower than that with negative expressions. And the overexpression of both CD34 and CD133 may be a poor prognostic factor. ⑤It is highly correlated among the expression of surviving, CD34 and CD133.