慢性粒细胞白血病的不同病期PTEN表达及其相关性研究

The significance of PTEN detection in different phases of chronic myeloid leukemia

目的探讨抑癌基因PTEN在慢性粒细胞白血病(CML)病情进展及预后中的意义。方法应用半定量RT-PCR和免疫组化技术分别检测55例CML患者和16例慢性再生障碍性贫血(CAA)及10例正常对照者(正常对照组)骨髓单个核细胞(BMMNC)中PTEN的表达情况。CML患者中慢性粒细胞白血病慢性期(CML-CP)29例(慢性期组),慢性粒细胞白血病加速期(CML-AP)9例(加速期组),慢性粒细胞白血病急变期(CML-BC)17例(急变期组)。分析PTEN与外周血白细胞数及Bcr/bal融合基因的关系,追踪疾病的转归。结果 PTEN基因阳性表达在对照组CAA 82.33%与正常人90%,两者比较差异无统计学意义(P>0.05)。55例CML患者PTEN阳性表达57.41%明显低于对照组,差异有统计学意义(P<0.01)。PTEN表达在慢性期组、加速期组、急变期组均明显低于正常对照组(P<0.05)。加速期及急变期的表达低于慢性期(P<0.05),在加速期和急变期的表达虽降低,但两者的差异无统计学意义(P>0.05)。各期PTEN表达与Bcr/bal融合基因无相关性,与患者外周血白细胞数呈正相关性(r≈0.50)。结论 PTEN参与了CML的发生、发展,且与CML的急变有一定相关性,PTEN基因可以作为CML病情进展及判断预后的有价值的分子标志物。

Objective To investigate the significance of tumor suppressor gene,PTEN,in chronic myeloid leukemia（CML） progression and prognosis.Methods Using semi-quantitative RT-PCR and S-P immunohistochemical,we detected PTEN expression in bone marrow mononuclear cells of the 55 patiants with different phases of CML was detected,of which 16 cases of chronic aplastic anemia（CAA） and 10 cases of normal as control.CML patients included 29 cases of chronic myeloid leukemia in chronic phase（CML-CP）,9 cases of Chronic Myeloid Leukemia in accelerated phase（CML-AP）,17 cases of chronic myeloid leukemia in blast crises（CML-BC）.We also did analysis on its relativity with peripheral blood leukocyte counts and Bcr/bal fusion gene was also analyzed,and did follow-up study on disease prognosis was done.Results The positive expression rate of PTEN in the control group CAA（82.33%） showed no significant difference（P0.05） from the normal group（90%）.The positive expression rate of PTEN in 55 CML patiants was 57.41%,which was significantly lower than that of controlgroup（P0.01）.The PTEN expression in the chronic phase group,accelerated phase gtoup and blast crises group were all significantly lower than that of normal control（P0.05）.In accelerated phase or blast crises of CML,the PTEN expression was lower than in chronic phase（P0.05）,but this difference was not significant（P0.05）.The expression of PTEN in all the different CML phases showed no correlation with Bcr/bal fusion gene but positively correlation with peripheral blood leukocyte counts in patients（r≈0.50）.Conclusion PTEN gene is involved in the CML occurrence and development,and has a certain correlation with CML in blast crisis.It can be used as a valuable molecular marker to monitor disease progression and prognosis of CML.