凋亡抑制基因aven在急性髓系白血病的表达及其临床意义

Expression of Antiapoptotic Gene Aven in De Novo Acute Myeloid Leukemia Patients and Its Clinical Significance

本研究旨在探讨AML患者凋亡抑制基因aven mRNA的表达情况,分析其临床意义,为预后评估提供实验依据。应用实时荧光定量PCR方法检测69例初诊AML患者外周血白细胞aven mRNA的表达水平,分析aven mRNA的表达水平与患者的年龄、性别、白细胞数,血小板计数、血红蛋白和LDH水平、外周血和骨髓的原始细胞比例、FAB分型、患者的疗效和复发的关系,21名正常人的外周血作为对照。结果表明:69例初诊AML患者aven mRNA表达水平的中位值为37.2(11.72-178.93)%,正常人外周血白细胞aven mRNA表达水平中位值为28.81(10.81-50.98)%,AML患者aven mRNA表达水平明显高于正常人(p=0.006)。aven mRNA的表达水平与患者的年龄具有明显的相关性(r=0.25,p=0.039),以AML患者中位年龄(44岁)为界分为2组,年龄大于/等于44岁组aven mRNA表达水平[中位值50.08%,(18.88-152.02)%]明显高于年龄小于44岁组[中位值32.41%,(11.72 -178.93)%],(p=0.018)。aven mRNA的表达水平与患者Hb水平和FAB分型具有明显的相关性(r=0.29,p=0.019;r=0.253,p=0.036)。2个化疗疗程后aven mRNA表达水平低于中位值组的完全缓解率(25/30,83.33%)高于aven mRNA表达水平高于中位值组(21/30,70%),但差别无统计学意义(p=0.22)。复发患者aven mRNA的表达水平与无复发者相比无明显升高(p=0.076)。结论:初诊AML患者凋亡抑制基因aven mRNA的表达水平明显升高,可能与AML的发病有关,但尚未发现基因aven mRNA的表达情况与疾病的疗效和复发之间的关系。

This study was aimed to investigate the aven mRNA expression level of leukocytes from peripheral blood （PB） of de novo patients with acute myeloid leukemia （AML） and analyze its clinical significance, so as to provide a experimental basis for evaluating prognosis. The aven mRNA expression levels in PB samples from 69 de novo AML patients were detected by using real-time quantitative PCR. The relation of aven mRNA level with clinical and hematological characteristics （age, sex, WBC, Hb, Plt, LDH, Blast% in PB and BM, FAB subtype） and treatment outcome （CR rate and relapse rate）were analyzed. 21 normal individuals served as controls. The results showed that the expression level of aven mRNA was between 11.72% and 178.93 % （ median 37.2% ） in de novo AML and between 10.81% and 50.98 % （ median 28.81% ） in normal individuals. Aven mRNA expression level was higher in the AML group than that in the controls （p = 0. 006 ）. As aven mRNA expression level was compared with other clinical and hematological parameters, there were significant correlations between aven mRNA expression level and age（ r = 0. 25 ,p =0.039）, and between hemoglobin level （r =0.29,p =0. 019）, FAB subtype（r =0. 253,p =0. 036）. The median expression level （50.08%） of aven mRNA in older patients （ ≥44 years） was higher then that （32.41%） in younger patients （ 〈44 years） （p =0. 018）. The complete remission（ CR）rate after two cycles of chemotherapy in patients with lower aven mRNA level （25/30,83.33 % ）was higher than that in patients with higher aven mRNA level（21/30,70% ）, but the difference was not significant（p =0.22 ）. The difference of aven mRNA expression level between AML patients with relapse and AML patents without relapse was not significant （p =0.076）. It is concluded that the expression level of avert mRNA in de novo AML patients obviously increases, the overexpression of aven mRNA likely involves in genesis of AML. The definite relation of aven mRNA expression level with treatment outcome and relapse was not been found.