nm23-H_1基因在儿童急性淋巴细胞白血病的表达及其对化疗疗效的影响

The expression of nm23-H_1 gene in childhood acute lymphoblastic leukemia and its effect on treatment outcome.

目的探讨儿童急性淋巴细胞白血病(ALL)不同阶段、不同类型患者nm23-H1基因的表达水平及其对化疗疗效的影响。方法研究对象为2006.12～2008.05哈尔滨市儿童医院血液科、哈尔滨医科大学附属第一医院儿科住院的ALL患儿。应用半定量逆转录-聚合酶链反应(RT-PCR)的方法,检测儿童急性淋巴白血病初治患者、缓解患者、难治患者、复发患者及正常对照儿童nm23-H1基因的表达;观察nm23-H1基因与疗效的关系。结果(1)初治患者nm23-H1表达水平明显高于正常对照组(P<0.01)和完全缓解组(P<0.01);完全缓解后nm23-H1表达水平与对照组无明显差异(P>0.05),复发/难治组患者nm23-H1表达水平高于正常对照组(P<0.01)和完全缓解组(P<0.01),与初治患者无明显差异(P>0.05);(2)40例初治患者nm23-H1阳性26例,nm23-H1阴性14例,nm23-H1阳性患者的完全缓解(CR)率与nm23-H1阴性患者无明显差异(分别为73.1%、92.9%,P>0.05),但完全缓解患者治疗前nm23-H1表达水平低于未缓解患者(P<0.01)。结论nm23-H1的表达水平随儿童ALL的病情发展而变化,nm23-H1可以作为判断疗效、预测复发、评估预后的一个因素;nm23-H1高表达可能是儿童ALL的不利因素,nm23-H1高表达者疗效差,易耐药,易复发,预后差。

Objectives： To study the expression of nm23 -H1 gene in children with acute lymphoblastic leukemia （ALL） and its effect on treatment outcome. Methods ： The research objects were the patients with acute lymphoblastic leukemia who came from hematology department of Harbin children＇s hospital and pediatrics department of the first affiliated hospital of the Harbin medical university from December, 2006 to MAY, 2008. Sem iquantitative RT - PCR was employed to measure the expression of nm23 - H1 in children with lymphoblastic leukemia and normal controls. , then studied the relationship between nm23 -H1 and treatment outcome. Results： （ 1 ） The expression level of nm23 - H1 of newly dioanosed patients was significantly higher than that of the normal controls （ P 〈 0. 01 ） and the remission group （ P 〈 0. 01 ）. There was no difference of the expression level of nm23 - H1 between the remission group and the normal controls （ P 〉 0.05）. The expression level of nm23 -H1 of relapse patients and the incurable patients was significantly higher than that of the normal controls （ P 〈 0. 01 ） and the remission group （ P 〈 0.01 ）, but has no difference when compared to the newly dioanosed group （ P 〉 0.05 ）. （2） The expression of nm23 - H1 was revealed in 26 of 40newly dioanosed patients, there was no difference of complete remission （CR） rate between nm23 -H1 positive patients and nm23 -H1 negative ones （73.1% , 92. 9%, P 〉 0. 05）, but the expression level of nm23 - H1 of the remission patients before treatment was lower than that of those who had no remission （ P 〈 0.01 ）. Conclusions ： The expression level of nm23 - H1 could reflect the patient＇s condition because it varied with the stages of the childhood acute lymphoblastic leukemia. High expression of nm23 - H1 might be an adverse effect on children with acute lymphoblastic leukemia, patients with high expression of nm23 -H1 had unsatisfied treatment outcome and easy to relapse, so they had poor prognosis.