初治急性髓系白血病患者MDR1和BAALC基因的表达情况及其与预后的关系分析

Expression of MDR1 and BAALC genes and its relationship with prognosis in patients with newly diagnosed acute myeloid leukemia

目的分析初治急性髓系白血病(AML)患者多药耐药蛋白1(MDR1)和脑和急性白血病胞质(BAALC)基因的表达情况及其与预后的关系。方法选取100例成人初治AML患者为研究对象,均接受蒽环类药物诱导化疗联合阿糖胞苷等治疗,检测MDR1和BAALC基因表达水平,分析其表达水平与AML患者临床特征、遗传学分型、治疗疗效及预后的关系。结果MDR1基因和BAALC基因高、低表达患者白细胞、血红蛋白、血小板等临床特征比较差异不显著(P>0.05)。不同染色体危险度分层患者MDR1基因表达水平比较有显著差异(P<0.05),BAALC基因表达水平比较无统计学意义(P>0.05)。经化疗干预后,MDR1基因高表达患者CR率60.78%显著低于MDR1基因低表达87.76%(P<0.05),BAALC基因高表达患者CR率67.31%略低于MDR1基因低表达81.25%,但差异无统计学意义(P>0.05)。MDR1基因高、低表达患者中位OS及OS率对比,差异有统计学意义(P<0.05);BAALC基因高、低表达患者中位OS及OS率对比,差异无统计学意义(P>0.05)。结论与BAALC基因表达相比,初治AML患者中,MDR1基因表达对评估治疗疗效及预后的价值更高,临床可联合MDR1和BAALC基因检测以提高初治AML患者的预测准确性。

Objective To investigate the expression of multidrug resistance protein 1(MDR1)and brain and acute leukemia cytoplasm(BAALC)genes and its relationship with prognosis in patients with newly diagnosed acute myeloid leukemia(AML).Methods A total of 100 adults with newly diagnosed AML were enrolled in the study.All patients were treated with anthracyclines induced chemotherapy combined with cytarabine.The expression levels of MDR1 and BAALC genes were detected,and the relationships with the clinical characteristics of patients with AML,genetic type,therapeutic effect and prognosis were analyzed.ResultsThere was no significant differences in white blood cells,hemoglobin and platelet between patients with high and low expression of MDR1 gene and BAALC gene(P>0.05).There were significant differences in the expression level of MDR1 gene between patients with different chromosome risk stratification(P<0.05)but there was no significant difference in the expression level of BAALC gene(P>0.05).After chemotherapy intervention,CR of patients with high expression of MDR1 gene was significantly lower than patients with low expression of MDR1gene(60.78% vs.87.76%)(P<0.05),CR of patients with high expression of BAALC gene was slightly lower than patients with low expression of MDR1gene(67.31% vs 81.25%)(P>0.05).Comparison of median overall survival(OS)and overall survival(OS)in patients with high and low expression of MDR1 gene.The difference was statistically significant(P<0.05).Comparison of median overall survival(OS)and overall survival(OS)in patients with high and low expression of BAALC gene.There was no significant difference(P>0.05).Conclusion Compared with the expression of BAALC gene,the value of expression of MDR1 gene is higher in evaluating the curative effect in patients with newly diagnosed AML.Combined detection of MDR1 and BAALC genes can improve the accuracy in predicting the prognosis of patients.