FLT3基因在急性髓细胞白血病中的表达及临床意义

Clinical Significance and Expression of Flt3 in Acute Myeloid Leukemia

目的研究急性髓细胞白血病(AML)患者FLT3的表达水平,探讨Fms样的酪氨酸激酶3(FLT3)在AML中的作用机制及临床意义.方法采用半定量RT-PCR方法检测70例AML患者和11例良性血液病为对照组FLT3表达水平.老年AML36例,非老年AML34例,其中初治组31例,完全缓解(CR)组15例,难治复发组24例.结果70例AMLFLT3表达水平明显高于对照组,差别有统计学意义(P<0.01);36例老年AML组与34例非老年AML组间FLT3表达水平无显著性差异(P>0.05);复发难治组FLT3表达水平最高,初治组居中,CR组最低,三者表达水平具有显著性差异(P<0.05);AML初治组按FAB亚型分组,M3组表达水平最低,与其它亚型有显著性差异(P<0.05);M2、M4、M6居中,三者间表达水平无显著性差异(P>0.05);M5组表达水平最高,与其它亚型有显著性差异(P<0.05).结论FLT3在AML中过度表达,以M5最为明显,提示FLT3在白血病的发病机制中有一定作用,与疾病进展及预后有关,在检测微小残留病方面,也可能有一定价值.

Objective To investigate expression level of FLT3 in acute myeloid leukemia （AML）, and evaluate the pathogenesis and clinical significance of FLT3 in AML. Methods The semi-quantitative RT-PCR method was performed to detect the expression levels of FLT3 in the bone marrow samples of 70 patients with AML, and 11 samples of benign hemopoietic patients. There were 36 samples with elderly AML and 34 samples with the non-elderly AML, include 31 patients with denovo AML, 15 the patients of complete remission, 24 from the patients of the refractory or relapse AML. Results The expression level of FLT3 in 70 patients with AML was significantly higher than the control group （P 〈 0.001 ）. There was no difference in the expression level of FLT3 between elderly AML and non-elderly AML （P 〉 0.05）. The expression level of the refractory or relapse AML was the highest, de novo AML was in the middle and the complete remission AML was the lowest. The difference of FLT3 expression level in three groups had statistic significance （P 〈 0.05 ）. In each of the FAB subtype of de novo AML, the M3 was obviously lower than other subtype （P 〈 0.05） ; the Ms was obviously higher than other subtype （P 〈 0.05） and there was no significant difference among M2, M4 and M6 （P 〉 0.05）. Gonclusion The over expression of FLT3 may play an important role in leukemogenesis. The expression lever of FLT3 is correlated with progression and prognosis of patients with elderly AML. It has the potential to be used as a mark to monitor the MRD （minimal residual disease）.