儿童急性淋巴细胞白血病nm23-H_1基因表达及其与免疫分型的关系

Expression of nm23-H_1 gene in childhood acute lymphoblastic leukemia and the relationship between nm23-H_1 expression and immunophenotype

目的探讨儿童急性淋巴细胞白血病(ALL)nm23-H1基因的表达水平及其与免疫分型的关系。方法应用半定量逆转录-聚合酶链反应(RT-PCR)的方法检测儿童ALL初治、缓解、难治、复发患儿及正常对照儿童nm23-H1基因的表达水平,观察nm23-H1基因与免疫表型的关系。结果①初治患儿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);完全缓解组nm23-H1表达水平与对照组差异无显著性(P>0.05),复发组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),与初治差异无显著性(P>0.05);难治组均为高表达。②T-ALL的nm23-H1阳性率高于B-ALL(P<0.05),且T-ALL的nm23-H1表达水平高于B-ALL(P<0.05)。结论nm23-H1的表达水平随儿童ALL的病情发展而变化,在初治、复发及难治ALL具有高表达,nm23-H1高表达者预后差,易复发;nm23-H1在T-ALL具有高表达,可能是T-ALL的缓解率低、预后差的原因之一。

Objective To study the expression of nm23-H1 gene in children with acute lymphoblastic leukemia （ALL） and the relationship between nm23-H1 expression and immunophenotype. Methods nm23-H1 expression was measured by semiquantitative RT-PCR in children with ALL （ newly diagnosed, n = 40 ; remission, n = 32 ; relapse, n = 16; refractory, n = 3 ）. Twenty normal children served as the control group. The relationship between nm23-H1 expression and immunophenotype was evaluated. Results The expression of nm23-H1 in the newly diagnosed ALL group was significantly higher than that in the control （P 〈 0.01 ） and the remission groups （P 〈 0.01 ）. There was no difference in the nm23-H1 expression between the remission and the control groups. The expression of nm23-H1 in the relapse group was significantly higher than that in the control （P 〈0.01 ） and the remission groups （P 〈0.01 ）, and similar to that in the newly diagnosed ALL group. The three children with refractory ALL had higher nm23-H1 expression. Both the positive rate and expression of nm23-H1 in children with T-lineage ALL were higher than in children with B-lineage ALL （P 〈0. 05）. Conclusions The expression level of nm23-H1 varies with the stages of ALL. Newly diagnosed, relapsed and refractory ALL children have higher nm23-H1 expression. High nm23-H1 expression may be associated with a poor prognosis and relapse. A higher expression of nm23-H1 in children with T-ALL may be contributed to a low remission rate and a poor prognosis.