SET基因在急性髓系白血病患者中的表达及其临床意义

Expression level of SET gene in acute myeloid leukemia and its clinical significance

目的 研究SET基因在急性髓系白血病（AML）患者中的表达水平及其临床意义.方法 采用实时定量PCR方法检测141例初发AML患者骨髓单个核细胞SET基因表达水平,并分析其与临床特征和疗效的关系.结果 141例初发AML患者均检测到SET基因的表达,中位表达水平为0.86（0.02～15.69）.SET基因表达水平与性别、年龄、骨髓原始细胞比例、血红蛋白水平、血小板计数、FAB分型及NPM1和FLT3-ITD基因突变、染色体核型等无明显相关性（P值均＞0.05）,但SET基因高表达组高白细胞（≥100×109/L）患者比例为31.0％,明显高于SET基因低表达组（11.4％,P=0.005）.141例AML患者中136例接受化疗,SET基因高表达组2个疗程完全缓解（CR）率（50.0％）显著低于SET基因低表达组（73.5％,P=0.005）.SET基因高表达组的中位总生存（OS）和无事件生存（EFS）时间分别为10和2个月,明显短于低表达组（分别为22和14个月,P值分别为0.001和0.005）;多因素COX模型分析显示,SET基因高表达是AML患者OS独立不良预后因素（P=0.002）;此外,在正常核型AML患者中,SET基因高表达组的中位OS时间、EFS时间分别为12和4个月,短于低表达组（分别为35和14个月）,差异有统计学意义（P值分别为0.010和0.026）.结论 SET基因高表达与AML不良预后相关,SET基因高表达可能是AML患者的不良预后分子标志.

Objective To investigate the expression level of SET gene in patients with acute myeloid leukemia （AML） and evaluate its significance. Methods The expression level of SET gene in 141 de novo AML patients was determined by real time quantitative PCR （RQ-PCR）, and its relationship with the clinical features and outcomes of these patients were analyzed. Results SET gene transcript level was detected in 141 AML patients with the median expression level of 0.86 （range 0.02- 15.69）. AML patients with higher SET gene expression had a higher level of white blood cell （WBC~〉100x 109/L） count than of lower SET gene expression ones （31.0% vs 11.4%, P=-0.005）. In the 136 patients who received treatment after diagnosis, higher SET gene expression group had lower complete remission rate （50.0%） than of lower expression cohort （73.5%） after two cycles of chemotherapy （P=0.005）. Survival analysis showed that patients with higher SET gene expression had significantly shorter overall survival （OS） （10 months vs 22 months, P=0.001） and event-free survival（EFS） （2 months vs 14 months, P=-0.005） than of lower SET gene expression ones. Multivariate COX regression analysis showed SET overexpression was an independent prognostic factor for OS. In the patients with the normal karyotype, higher SET expression group also had significantly shorter OS （12 months vs 35 months, months, P=0.026） than of lower SET expression ones. Conclusion P=0.010） and EFS （4 months vs 14 High expression of SET gene was associated with poor prognosis and might be a prognostic molecular marker of AML.