E2F1基因在急性白血病中的表达及其临床意义

Expression of E2F1 Gene in Acute Leukemia and Its Clinical Significance

目的:研究E2F1基因在急性白血病中的表达变化及其临床预后意义。方法:选取从2015年3月-2016年3月在本院确诊为急性白血病(AL)的72例患者,同时选取24例健康体检者作为对照,采用RT-PCR和Western blot方法分析2组E2F1基因表达变化,同时采用统计学分析E2F1基因表达与AL患者临床指标的关系及其预后意义。结果:AL患者中E2F1基因m RNA和蛋白表达水平均明显高于对照组(P<0.05)。E2F1基因高表达患者的WBC、β2-M G、LDH水平均明显高于E2F1基因低表达的患者(P<0.05),但E2F1基因的表达与患者的性别、发热、疲劳、骨髓原始细胞比例、外周血原始细胞水平无相关性(P>0.05)。E2F1基因的低表达的患者完全缓解率显著高于E2F1基因的表达高的患者(P<0.05),而E2F1基因的低表达的患者耐药性低于E2F1基因高表达的患者(P<0.05)。治疗后症状缓解患者的E2F1基因的表达水平下降明显(P<0.05)。治疗后M1、M2、M5患者的E2F1基因的表达水平下降明显(P<0.05)。经Kaplan-M eier生存分析发现,E2F1基因低表达的患者组的OS和DFS优于高表达组(P<0.05)。多因素Cox回归分析表明,年龄和E2F1基因是OS独立影响因素(P<0.05);性别和E2F1基因是DFS独立影响因素(P<0.05)。结论:E2F1基因在AL患者中表达水平较高,其高水平表达与患者的预后不良密切相关。E2F1基因有望作为临床治疗AL患者的生物学靶点。

Objective： To investigate the expression of E2F1 gene in patients with acute leukemia （AL） and its clinical significance. Methods：Seventy - two AL patients treated in March 2015 - March 2016 in our hospital were selected, and 24 healthy people were selected as controls. RT-PCR and Western blot were applied to determine the level of E2F1 gene transcription and expression, and the statistical analysis was performed to reveal the clinical value of E2F1 gene. Results： The relative expression levels of E2F1 gene and protein in bone marrow of AL patients was higher than that in control group （ P 〈 0.05 ）. The levels of WBC, β2 - MG and LDH in the patients with high expression of E2F1 gene were higher than those in patients with low expression of E2F1 gene（ P 〈 0.05 ）, but the E2F1 gene expression did not correlate with sex, fever, fatigue, bone marrow blast ratio, peripheral blood blasts ratio （P 〉 0.05 ）. The complete remission （CR） of patients with low expression of E2F1 was significantly higher than that of patients with high expression of E2F1 （ P 〈 0.05 ）. And the drug resistance in the patients with low expression of E2F1 gene was lower than that of patients with high expression of E2F1 gene （ P 〈 0. 05 ）. The expression level of E2F1 gene decreased significantly in patients with symptomatic remission after treatment （P 〈 0. 05 ）. The expression levels of E2F1 gene in M1, M2 and M5 patients decreased significantly after treatment （P 〈 0. 05 ）. Kaplan-Meier survival analysis showed that OS and DFS in the patients with low expression of E2F1 gene were higher than those in patients with high expression （P 〈0.05）. Multivariate Cox regression analysis showed that the age and E2F1 gene were the independent influencing factors of OS （P 〈 0.05 ） ; the sex and E2F1 gene were the dependent factors of DFS （ P 〈 0. 05 ）. Conclusion： The expression level of E2F1 gene in patients with AL has been found to be higher, the higher level of E2F1 gene closely relates with AL patients, E2F1 gene can be used as a biological target for the clinical treatment of AL.