不同分型急性髓系白血病患儿骨髓细胞miR-125b表达的意义

Expression of miR - 125b in different subtypes of pediatric acute myeloid leukemia and its prognostic value

目的探讨不同分型及治疗前后急性髓系白血病（AML）患儿骨髓细胞中miR．125b的表达及临床意义。方法采用实时荧光定量PCR（qRT—PCR）技术检测65例AML患儿（骨髓样本均来源于中山大学孙逸仙纪念医院住院患者）治疗前后骨髓细胞miR-125b的表达，分析其治疗前后的表达水平变化与AML患者性别、年龄、白细胞计数、分型、复发及临床疗效的关系。对照组来源于中山大学孙逸仙纪念医院妇产科健康孕妇足月顺产分娩时采集的脐血标本。结果初诊AML患儿及对照组儿童miR-125b的阳性表达率均为100％。qRT—PCR结果显示，miR-125b在对照组的表达量为1．50，AML的表达量为11．06，差异有统计学意义（P〈0．05）。急性早幼粒细胞白血病型（M3型）AML中，化疗后miR．125b降低组的完全缓解率为91．3％，而化疗后miR-125b升高组的完全缓解率为50．0％，2组相比差异有统计学意义（P=0．0426）。化疗后miR-125b的相对表达量（19．2±6．0）较化疗前（29．7±4．9）明显降低，差异有统计学意义（P=0．0366）。在非M3型AML中，化疗后miR-125b降低组的完全缓解率为86．7％，化疗后miR-125b升高组的完全缓解率仅为42．1％，2组相比差异有统计学意义（P=0．0215）。未发现miR-125b表达水平与患儿性别、年龄及外周血白细胞数之间的相关性。结论miR-125b的表达差异在儿童AML的发生发展中起重要作用，其表达信息可能与儿童AML的治疗效果和预后有关。因此，miR-125b的监测有可能为AML患儿的个体化治疗提供-定的实验依据。

Objective To investigate the expression and clinical significance of miR - 125b in patients before and after treatment of acute myeloid leukemia （AML） with different types. Methods The levels of miR - 125b were measured by using real -time fluorescence quantification PCR （qRT -PCR） in 65 AML patients （all AML samples from the Sun Yat - Sen Memorial Hospital of Sun Yat - Sen University, and the control samples isolated from cord blood which were obtained after normal full - term delivery, of babies） before and after treatment, and then the relationship be- tween the levels of miR- 125b and patients＇ sex, age, peripheral blood cells, type clinically, relapse and therapeutic effect were analyzed. Results Of newly diagnosed AML patients and the control samples,miR - 125b positive rate was 100%. The miR - 125b expression levels in the control group was 1.50, and its expression in AML was 11. 06, and the difference was significant （ P = 0.036 6）. In complete remission （CR） group of acute promyelocytic leukemia （ M3 ） , the expression of miR - 125b after induction therapy was significantly reduced, and CR rate of miR - 125b decreased group was 91.3% , while that of the increased group was 50.0% , and the difference was significant （ P = 0. 042 6 ）. The miR - 125b expression level was decreased from 29.7 ± 4.9 to 19.2 ± 6.0 after chemotherapy, and the difference was significant （ P 〈 0. 036 6 ）. In non - M3 AML, CR rate of miR - 125b decreased group was 86.7% , while that of the in- crease group was 42.1% , and the difference was significant （ P = 0. 021 5 ）. There was no correlation between miR - 125b expression and patients＇ gender, age and peripheral blood cells. Conclusions The differences in expression of miR - 125b is very important in disease occurrence and progress. Using qRT - PCR to dynamically detect the expression of miR - 125b dynamically in AML patients before and after therapy may predict outcome more precisely and has the potentials as an effective biomarker in determining prognosis, monitoring the risk of recurrence, and guiding the treatment.