初治急性髓系白血病成年患者I-mfa基因表达水平及临床意义的研究

Expression level and clinical significance of I-mfa gene in adult patients with de novo acute myeloid leukemia

目的探讨初治急性髓系白血病（AML）成年患者I-mfa基因表达水平及其与疾病发展、预后的临床意义。方法选择110例AML患者,其中男性66例,女性44例;年龄14-77岁,中位年龄32岁。通过实时荧光定量聚合酶链反应（realtime PCR）方法检测初治AML成年患者骨髓标本I-mfa基因的表达水平,分析其与疾病特征、临床疗效间的关系。结果以110例初治AML成年患者I-mfa基因表达量的中位数为分界点,将患者分为I-mfa基因低表达组66例和高表达组44例。在初治AML成年患者中,I-mfa基因表达水平在年龄、性别、FAB分型、外周血象、原始细胞比例、遗传学危险度分层及CD34表达间差异无统计学意义（P〉0.05）。I-mfa基因低表达组完全缓解（CR）率高于高表达组,差异有统计学意义（81.8%vs 59.1%,P=0.032）。I-mfa基因低表达组中位生存时间622 d（17-1 787 d）,而高表达组患者中位生存时间418 d（14-1 806 d）,差异有统计学意义（P=0.021）。结论 I-mfa基因低表达组初治AML成年患者CR率显著高于高表达组,其中位生存时间亦较高表达组长,提示I-mfa基因高表达AML成年患者可能预后较差,值得进一步研究。

Objective To investigate the expression level of I-mfa gene and its clinical significance in the prognosis of acute myeloid leukemia（AML） adult patients. Methods A total of 110 AML patients were enrolled, which included 66 males and 44 females, aged 14- 77 years old with median age of 32 years old. Quantitative real-time reverse transcriptase polymerase chain reaction（RT-PCR） was performed to detect the expression level of I-mfa gene in 110 cases of de novo AML patients, and the relationship between the characteristics and clinical effect was analyzed. Results The median value was used as segmentation point, 110 cases were divided into I-mfa gene low expression group（n = 66） and high expression group（n = 44）. There was no statistically significant difference in age, gender, FAB typing, peripheral blood cells, blast counts of bone marrow and peripheral blood, multiple gene expression levels, chromosome risk stratification and CD34 expression of de novo AML patients（P〉0.05）. For I-mfa gene low expression group, the complete remission（CR） rate was higher than that of high expression group（81.8 % vs 59.1 %, P = 0.032）, the overall survival（OS） time of I-mfa gene low expression group was 622 days（17-1 787 days） and high expression group was 418 days（14- 1 806 days）, the difference was statistically significant（P = 0.021）.Conclusion It is demonstrated that in de novo AML patients, CR of I-mfa gene low expression group is significantly higher than that of high expression group, and OS is also longer than that of high expression group. It is suggested that I-mfa gene high expression in AML patients may result in poor prognosis for treatment, which should be paid more attention in further study.