淋巴增强因子1在多发性骨髓瘤中的表达及其临床意义

Expression of lymphoid enhancing factor-1 in multiple myeioma and its clinical significance

目的 探讨多发性骨髓瘤（MM）患者初诊及化疗后骨髓单个核细胞中淋巴增强因子1（LEF-1）mRNA表达及其临床意义.方法 应用实时荧光定量聚合酶链反应（RFQ-PCR）测定42例MM初诊患者LEF-1 mRNA表达水平.并以20例明确血液系统非恶性疾病患者为对照组.结果 初诊MM患者LEF-1 mRNA中位表达水平高于对照组[0.01068（0.00017~0.14100）比0.00101（0.00009~0.00233）],差异有统计学意义（U=91.00,P〈0.001）;MM患者化疗后LEF-1 mRNA中位表达水平较化疗前下降[0.00011（0.00001~0.01548）比0.01068（0.00017~0.14100）],差异有统计学意义（U=343.0,P〈0.001）;化疗后MM疾病进展（PD）组患者LEF-1 mRNA中位表达水平高于非PD组[0.08386（0.00288~0.14100）比0.00345（0.00016~0.05660）],差异有统计学意义（U=343.0,P〈0.001）;初诊时LEF-1 mRNA表达水平相对较高的MM患者2年总生存（OS）率更低[高表达组为47.6%,低表达组为65.5%],差异有统计学意义（χ2=3.931,P=0.0414）.结论 LEF-1可能参与MM的发生、发展,LEF-1水平可能是评估MM患者预后不良及PD指标,且其可能成为有效治疗MM的新靶点.

Objective To investigate the mRNA level of lymphoid enhancing factor-1 （ LEF-1） in bone marrow mononuclear cells after the initial diagnosis and chemotherapy of patients with multiple myeloma （MM） and its clinical significance. Methods The LEF-1 mRNA of target gene in 42 MM patient was detected by real-time fluorescence quantitative polymerase chain reaction （RTQ-PCR）, and 20 patients without hematological disease were enrolled as the healthy controls. Results The LEF-1 mRNA median level in previously diagnosed MM patients was significantly higher than that in the healthy controls [0.01068 （0.00017 - 0.14100） vs. 0.00101 （0.00009 - 0.002326）], and the difference was statistically significant （U = 91.00, P〈 0.001）; The LEF-1 mRNA median level in MM patients after chemotherapy was declined compared with the patients before chemotherapy [0.00011 （0.00001 - 0.01548） vs. 0.01068 （0.00017 -0.14100）], and the difference was statistically significant （U = 343.0, P〈 0.001）. The LEF-1 mRNA median level of MM patients after chemotherapy in progression of disease （PD） group was higher than that in the non-PD groups [0.08386 （0.00288 - 0.14100） vs. 0.003454 （0.000156 - 0.05660）], and the difference was statistically significant （U = 343.0, P〈 0.001）. The overall survival （OS） rate in the high LEF-1 expression group was shorter than that in the low LEF-1 expression group for MM patients in the initial diagnosis （47.6%vs. 65.5 %, χ2 = 3.931, P= 0.0414）. Conclusion LEF-1 may be involved in the occurrence and development of MM, which has a potential to become an indicator of evaluating the poor prognosis and PD of MM patients, and could be served as a novel therapy target for the treatment of MM.