增殖诱导配体及其受体mRNA水平的定量测定在儿童淋巴瘤诊断中的价值

Role of measuring the expression levels of a proliferation-inducing ligand and its receptors by real-time fluorescence quantitative method in children with lymphoma

目的 探讨增殖诱导配体（APRIL）及其受体mRNA水平的定量测定在儿童淋巴瘤早期诊断中的价值.方法 采用实时荧光定量聚合酶链反应技术定量测定87例儿童外周血APRIL及其受体的表达,其中霍奇金病10例、非霍奇金淋巴瘤37例、健康对照40例.并分析APRIL及其受体mRNA表达水平与恶性淋巴瘤不同分期的相关性,以靶基因mRNA和p2微球蛋白（p2M）mRNA含量的比值作为评价APRIL及其受体表达水平的指标.结果 47例儿童淋巴瘤样本APRIL（1.13±0.09）及其受体[B细胞成熟抗原（BCMA）：1.22±0.11、跨膜激活物和CAML结合物（TACI）：0.89±0.12]mRNA的水平均显著高于健康儿童（0.41±0.09、0.43±0.10、0.35±0.08,均P＜0.05） APRIL及其受体mRNA的水平在霍奇金病组和非霍奇金淋巴瘤组间差异均无统计学意义（均P＞0.05） APRIL在非霍奇金淋巴瘤Ⅰ期（0.88±0.06）和Ⅱ期（0.90±0.08）中表达水平显著低于Ⅲ期（1.21±0.09）和Ⅳ期（1.23±0.09,P＜0.05）,而其受体在各分期之间表达差异无统计学意义（P＞0.05）.结论 APRIL表达水平与恶性淋巴瘤的病理分期有相关性,并在恶性淋巴瘤病变演进过程中呈现累积和渐进趋势,外周血APRIL及其受体测定有可能成为恶性淋巴瘤早期重要的预后因素.

Objective To investigate the role of a real-time fluorescence quantitative polymerase chain reaction （PCR） in measuring the expression levels of a proliferation-inducing ligand and its receptors expression levels in peripheral blood of children with lymphoma. Methods Real-time fluorescence quantitative PCR was used to detect the expression levels of a proliferation-inducing ligand and its receptors in patients with Hodgkin disease （n = 10） or non-Hodgkin lymphoma （n =37） and healthy control （n =40）. The correlation between the mRNA levels of a proliferation-inducing ligand and its receptors and differential stage of malignant lymphoma was analyzed. Results The results of 47 samples showed that the levels of prolifevation-inducing ligand, B cell maturation antigen, transmembrane activator and CAML interactor in the peripheral blood of lymphoma in children were significantly higher than those in normal children （1.13 ±0.09 vs 0.41 ±0.09, 1.22 ±0.11 vs 0.43 ±0.10, 0.89 ±0.12 vs 0.35 ±0.08, all P〈0.05）. The level of a proliferation-inducing ligand and its receptors had no significant difference between Hodgkin disease and non-Hodgkin lymphoma （ P 〉 0.05）. The level of a proliferation-inducing ligand in Ⅰ -Ⅱ stage （0.88 ± 0.06, 0.90 ± 0.08 ） of malignant lymphoma in children was significantly lower than that in Ⅲ-Ⅳ stage（ 1.21 ± 0.09, 1.23 ± 0.09, P 〈 0.05 ） while the level of its receptors between various stages showed no difference （P 〉 0.05）. Conclusion The real-time fluorescence quantitative PCR has a high sensitivity and reproducibility. A proliferation-inducing ligand may play a great role in the development and progression of malignant lymphoma in children through its receptors of B cell maturation antigen,transmembrane activator and CAML interactor. A proliferation-inducing ligand and its receptors can be established as target molecules for early diagnosis and anti-cancer therapy.