分化抑制因子1基因在急性髓系白血病患者骨髓单个核细胞中的表达

Expression of inhibitor of differentiation-1 gene in bone marrow mononuclear cells of patients with acute myeloid leukemia

目的:探讨分化抑制因子1(inhibitor of differentiation-1,ID1)基因在急性髓系白血病(acute myeloid leukemia,AML)患者骨髓单个核细胞中的表达及其临床意义。方法:应用实时定量PCR方法检测153例初诊AML患者骨髓单个核细胞ID1基因的转录本水平。结果:ID1基因的表达范围为0.000~3.536(中位为0.030)。以中位数值为界将AML患者分为高表达组和低表达组,两组AML患者性别、外周血小板计数以及常见基因突变无统计学差异(P>0.05),外周血白细胞计数、外周血血红蛋白、FAB分型、WHO分型、核型分组及核型危险程度分组趋近统计学差异(P<0.10)。ID1高表达患者年龄以及骨髓原始细胞比例显著高于ID1低表达患者(P=0.033、0.035)。ID1高表达组患者经治疗后完全缓解率低于ID1低表达组(P<0.01),且定量分析显示经1~2个疗程诱导化疗获得完全缓解的AML患者初诊时ID1表达水平显著低于未获得完全缓解的AML患者(P=0.001)。生存分析显示在全部患者、非M3患者或正常核型AML患者中,ID1高表达患者总体生存时间均明显短于ID1低表达患者(P=0.002、0.008和0.050)。结论:ID1基因表达水平可作为AML患者化疗反应以及预后判断的分子标志。

To explore the expression of inhibitor of differentiation-1(ID1)gene in bone marrow mononuclear cells and its clinical significance in patient with acute myeloid leukemia(AML).Methods:Real-time quantitative PCR was applied to detect ID1transcript level in bone marrow mononuclear cells from153de novo AML patients.Results:ID1transcript level in AML patients ranged from0.000to3.536(median0.030).According to the median level of ID1expression,AML patients were divided into two groups,i.e.high ID1expression and low ID1expression.No significant differences were found in sex,peripheral platelet,and common gene mutations between two groups(P>0.05).There were tendency towards the differences between two groups in peripheral white blood cell,peripheral hemoglobin,FAB subtypes,WHO classifications,karyotypes,and karyotypic risks(P<0.10).However,significant differences were observed in age and percentage of bone marrow blasts between two groups(P<0.05),and high ID1expression was associated with older age(P=0.033)and higher percentage of bone marrow blasts(P=0.035).Patients with high ID1expression presented a significantly lower complete remission(CR)rate than those with low ID1expression(P<0.01),and AML patients who can achieve CR in1-2course of induction chemotherapy showed a significantly lower ID1expression in newly diagnosis time than those who cannot achieve CR in1-2course of induction chemotherapy(P=0.001).Survival analysis showed that patients with high ID1expression had a shorter overall survival(OS)than those with low ID1expression in whole AML,non-M3AML,and cytogenetically normal AML(P=0.002,0.008,and0.050,respectively).Conclusion:The level of ID1expression may act as a potential biomarker associated with chemotherapy response and prognosis in AML.