cdx2基因在儿童白血病的表达及临床意义研究

Expression of cdx2 Gene in Pediatric Patients with Leukemia and Its Clinical Significance

本研究旨在探讨cdx2基因在儿童急性白血病骨髓及外周血单个核细胞中的表达及临床意义。采取33例初发儿童白血病患儿骨髓及外周血,运用RT-PCR方法检测cdx2基因在各型白血病及正常对照组中的表达,随访25例并观察其与疗效的关系。结果发现,病例组中30例急性白血病(AL)患儿cdx2表达阳性25例(83.3%),30例中21例急性淋巴细胞白血病(ALL)和9例急性髓细胞白血病(AML)cdx2表达阳性分别为20例(95.2%)和5例(55.6%),两组相比有统计学意义(p<0.05);3例慢性粒细胞白血病(CML)中1例cdx2表达阳性。对照组20例健康体检者外周血cdx2表达阴性,与病例组比较差异有统计学意义(p<0.01)。25例AL患儿cdx2阳性21例(ALL17例,AML4例)与阴性者4例(ALL1例,AML3例)经治疗后均达到完全缓解(CR)。cdx2是否阳性表达可能与CR率无相关关系。对8例cdx2表达阳性AL患儿治疗后动态观察,结果初诊cdx2阳性表达在CR时仍阳性,但随着CR延长cdx2表达逐渐转为阴性,而初诊时cdx2阴性表达在骨髓CR时仍为阴性。结论:cdx2在儿童AL患者中广泛高表达,ALL者该基因表达阳性率高于AML患儿。CML患儿中也有cdx2表达;cdx2基因表达与AL患者CR率无明显相关。

This study was aimed to investigate the expression of cdx2 gene in pediatric patients with acute leukemia and its clinical implication.The bone marrow and peripheral blood were collected from 33 newly diagnosed pediatric patients with acute leukemia,the cdx2 gene expression in each AL subtypes and normal controls was detected by RT-PCR,the relationship between cdx2 expression and response to treatment was observed.The results showed that the expression of cdx2 was positive in 25 out of 30 AL cases（83.3%）,to be exact,in 20 of 21 ALL cases（95.2%） and in 5 of 9 AML cases（55.6%）,which showed statistical difference（p0.05）.The cdx2 mRNA could be detected also in 1 of 3 CML cases.However,no expression of cdx2 was observed in all normal control which revealed significant difference between patient group and normal control group.21 AL patients with cdx2 positive expression（17 ALL and 4 AML patients） and 4 AL patients with cxd2 negative expression（1 ALL and 3 AML patients） all reached complete remission（CR） after treatment,which showed no correlation with CR rate.8 patients with positive cdx2 expression were followed up.As a result,the cdx2 positive expression at initial diagnosis of patients remained positive at reaching CR,but it gradually turned to negative along with prolonging of CR,while the cdx2 negative expression at initial diagnosis of patients remained negative at CR in bone marrow level.It is concluded that cdx2 positive expression is observed in the majority of pediatric AL patients,even positive rate in ALL patients is higher than that in AML patients,while the cdx2 expression also can be observed in CML patients.The cdx2 positive expression is not related to the CR rate in AL patients.