LKB1基因在急性淋巴细胞白血病患者中的表达水平与病情的相关性

Expression Level of LKB1 Gene in Patients with Acute Lymphoblastic Leukemia and Its Correlation with Illness Condition

目的:探讨急性淋巴细胞白血病(ALL)患者体内LKB1基因的表达水平,分析患者病情与LKB1基因表达水平的相关性。方法:选择本院住院治疗的白血病患者98例,根据诊断结果的不同分为:ALL组56例,ANLL组42例。选取同时期50例健康体检者作为对照组。3组患者的静脉血分离单个核细胞,应用RT-PCR检测并比较各组的LKB1基因表达水平。根据ALL患者LKB1基因表达水平分为2个亚组:低表达组(39例),高表达组(17例)。随访3年,应用Kaplan-Meier法绘制2组ALL患者的OS及DFS曲线。比较2组CR及复发比例的差异。应用多因素Logistic回归分析影响ALL患者生存相关的危险因素。结果:LKB1基因表达水平对照组为1.56(1.38-1.74)>ALL组1.32(1.22-1.40)>ANLL组0.89(0.78-1.02),3组比较具有统计学差异(P<0.05)。与低表达组比较,高表达组CR率显著较高,而复发比例较低(均P<0.05)。随访3年,LKB1高表达的ALL患者OS和DFS率均优于LKB1低表达的ALL患者(P<0.05)。LKB1基因表达水平与ALL患者危险分层存在负相关(r=-0.712,P=0.039),其中标危ALL,LKB1基因低表达组患者显著少于高表达组(P=0.014),而高危ALL,LKB1基因低表达组患者显著高于高表达组(P=0.002)。多元Logistic回归分析显示,年龄(OR=2.872,P=0.020)、外周血幼稚细胞数(OR=2.268,P=0.028)为ALL患者生存相关的危险因素,而LKB1表达水平(OR=0.426,P=0.016)为保护因素。结论:ALL患者体内LKB1基因呈低表达水平,且表达水平越低ALL病情越严重,预后越差。

Objective:To evaluate the expression level of LKB1 gene in patients with acute lymphoblastic leukemia(ALL),and analyze its correlation with illness condition of patients.Methods:The 98 patients with leukemia in our hospital were divided into two groups according to the diagnosis of patients:ALL group(56 cases)and ANLL group(42 cases).The 50 healthy persons subjected to physical examination were selected as control group.The peripheral blood mononuclear cells(PBMNC)were separated from the venous blood samples of three groups,and the expression levels of LKB1 gene were detected by RT-PCR and were compared among three groups.Patients in ALL group were divided into two groups according to the expression level of LKB1 gene:low expression group(39 cases)and high expression group(17 cases).Follow-up 3 years,the curves of OS and DFS in two groups were gained by Kaplan-Meier analysis.The ratios of CR and recurrence were compared between two groups.The related risk factors(all P<0.05)influencing the survival of patients with ALL were confirmed by multivariate logistic analysis.Results:The expression level of LKB1 gene of control group was 1.56(1.38-1.74)>ALL group 1.32(1.22-1.40)>ANLL group 0.89(0.78-1.02).There were statistical differences among the three groups(all P<0.05).Compared with low expression group,the CR rate in high expression group were higher,but the recurrence rate were lower in high expression group(all P<0.05).Follow-up 3 years,the OS and DFS rates in high expression group were higher than those in lowexpression group(all P<0.05).There was negative relation between expression level of LKB1 gene and clinical risk level of ALL patients(r=-0.712,P=0.039).For standard risk ALL,the patients in LKB1 low expression group was significantey lower than that in high expression group;and for high risk ALL,the patients in LKB1 low expression group was significant higher than that in high expression group.Multivariate logistic analysis showed that the age(OR=2.872,P=0.020),peripheral blood immature cell count(OR=2.268,P=0.028)were independent risk factors for survival of patients with ALL,and the expression level of LKB1 gene(OR=0.426,P=0.016)is protective factor.Conclusion:The expression level of LKB1 gene in patients with ALL is low,moreover the more low expression level of LKB1 gene were,the more severe ill condition and more poor prognosis were.