急性淋巴细胞白血病患者ROCK1基因表达水平变化及其临床意义

Change of ROCK1 Gene Expression Level in Patients with Acute Lymphoblastic Leukemia and Its Clinical Significance

目的:研究ROCK1基因在急性淋巴细胞白血病(ALL)患者中的表达变化及其临床预后意义。方法:选择自2017年4月-2018年4月在本院接受治疗的60例ALL患者,同时选取60例健康体检者作为对照,从受试者静脉取血后分离单个核细胞,采用RT-PCR实验检测样本的ROCK1基因表达水平,采用Western blot实验检测ROCK1蛋白表达水平,统计学分析ROCK1基因表达与ALL患者临床特征的相关性。结果:ALL患者ROCK1基因相对表达水平为1.37(1.28-1.46),对照组ROCK1基因相对表达水平为1.06(0.96-1.12),ALL患者ROCK1基因水平显著高于对照组(P<0.05)。ALL患者ROCK1蛋白表达水平高于对照组(P<0.05)。ROCK1基因表达水平与ALL患者的年龄、白细胞计数、乳酸脱氢酶(LDH)水平及外周血幼稚细胞数有显著相关性(P<0.05)。ROCK1基因表达水平与ALL患者的性别、血红蛋白(Hb)水平、血小板数及免疫表型无相关性(P>0.05)。ROCK1低表达的B-ALL和T-ALL患者患者标危比例均显著高于ROCK1高表达的患者(P<0.05)。ROCK1低表达的B-ALL和T-ALL患者极高危比例均显著低于ROCK1高表达的患者(P<0.05)。ROCK1低表达组CR比例显著高于ROCK1高表达的患者(P<0.05)。ROCK1低表达组复发比例显著低于ROCK1高表达的患者(P<0.05)。Kaplan-Meier生存分析表明,ROCK1低表达ALL患者的OS和DFS均优于ROCK1高表达的患者(P<0.05)。多因素Cox回归分析结果表明,年龄及ROCK1基因是OS独立影响因素(P<0.05);白细胞计数及ROCK1基因是DFS独立影响因素(P<0.05)结论:ROCK1基因在ALL患者中表达水平较高,其高水平表达可能刺激ALL的发生,而下调ROCK1基因表达可能有助于提高ALL的治疗效果。

Objective:To investigate the expression change of ROCK1 gene in patients with acute lymphoblastic leukemia(ALL)and its prognostic significance.Methods:Sixty patients with ALL were selected in our hospital from April 2017 to April 2018,and 60 healthy persons subjected to physical examination were selected as control.The venous blood was taken from the subjects,and then the mononuclear cells were separated.The ROCK1 gene expression level in the samples was detected by RT-PCR,and the expression level of ROCK1 protein was detected by Western blot.The correlation between ROCK1 gene expression and clinical characteristics of ALL patients was analyzed by using statistical methots.Results:The RT-PCR showed that the relative expression level of ROCK1 gene in ALL patients was1.37(1.28-1.46),which was significantly higher than that in the control group(P<0.05).Western blot showed that the protein expression level of ROCK1 in ALL patients was higher than that in the control group(P<0.05).The expression level of ROCK1 gene correlated with age,WBC count,lactate dehydrogenase(LDH)level,peripheral blood immature cell count,and risk stratification of ALL patients(P<0.05).The expression level of ROCK1 gene did not correlate with sex,hemoglobin(Hb)level,platelet count and immunophenotype in ALL patients(P>0.05).The standard risk ratio of B-ALL and T-ALL patients with low ROCK1 expression was significantly higher than that in patients with high ROCK1 expression(P<0.05).The high risk ratio of B-ALL and T-ALL patients with low ROCK1 expression was significantly lower than those with high ROCK1 expression(P<0.05).The ratio of CR in the group with low ROCK1 expression patients was significantly higher than that in patients with high ROCK1 expression(P<0.05).The Relapse rate of the group with low ROCK1 expression was significantly lower than that of the group with high ROCK1 expression(P<0.05).Kaplan-Meier survival analysis showed that OS and DFS in ALL patients with low ROCK1 expression were superior to those in ALL patients with high ROCK1 expression(P<0.05).Multiple factor Cox regression analysis showed that age and ROCK1 gene were independent influencing factors for OS(P<0.05);leukocyte count and ROCK1 gene were independent influencing factors for DFS(P<0.05).Conclusion:The expression level of ROCK1 gene in ALL patients is high,which may stimulate the genesis of ALL,and the down-regulation of ROCK1 gene expression may help improve the therapeutic effect for ALL patients.