T细胞型急性淋巴细胞白血病患者HOX11L2基因的表达及其临床意义

Expression and Clinical Significance of HOX11L2 Gene in Patients with T Cell Acute Lymphoblastic Leukemia

目的研究T细胞型急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)患者HOX11L2基因的表达及其临床意义。方法采用回顾性分析方法对50例患者性别、年龄、白细胞数量、FAB分类(L1,L2 and L3)、分子生物学特点以及生存时间进行分析,观察HOX11L2基因表达与临床特点及预后关系。结果50例T细胞型急性淋巴细胞白血病患者中,表达HOX11L2基因患者为12例(24%),其中男性7例(58.3%),女性5例(41.7%),HOX11L2基因表达者在男女性别之间的比较,差异无统计学意义(χ^2=0.119,P=0.730)。表达HOX11L2基因患者年龄在5~10岁间居多,表达率为58.3%,与其它年龄组之间的比较,差异有统计学意义(χ^2=11.577,P=0.018)。HOX11L2基因表达患者中白细胞计数≤50×10^9/L的患者10例(83.3%),白细胞计数>50×10^9/L的患者2例(16.7%),两组比较差异有统计学意义(χ^2=5.469,P=0.019)。FAB分类中,有75%的HOX11L2基因表达患者为L1型,与L2和L3组相比较,差异有统计学意义(χ^2=8.766,P=0.008)。其中34例获得随访资料的患者,HOX11L2基因表达组比非表达组生存时间短(中位生存时间分别为8.0个月和11.0个月),两组差异具有统计学意义(P<0.05)。结论研究结果表明HOX11L2基因主要表达于T-ALL患者,且以L1型儿童T-ALL为主,HOX11L2基因表达者预后不良,生存时间短。临床上通过HOX11L2基因检测结果与常规细胞形态学、遗传学、荧光原位杂交等技术检测结果相结合,将对急性淋巴细胞白血病的鉴别诊断、分型、预后及微小残留病检测等具有十分重要的意义。

Objective To study the expression and clinical significance of HOX11L2 gene in patients with T-cell acute lymphoblastic leukemia(T-ALL).Methods The sex,age,eukocyte count,FAB classification(L1,L2 and L3),molecular biological characteristics and survival time of 50 patients were analyzed retrospectively.The relationship between HOX11L2 gene expression,clinical characteristics and prognosis was observed.Results Among the 50 patients with T-ALL,12(24%)expressed HOX11L2 gene,7(58.3%)males and 5(41.7%)females.There was no significant difference between the two groups in gender(χ^2=0.119,P=0.730).Most of the patients with HOX11L2 gene were aged 5~10 years old,the expression rate was 58.3%,compared with other patients,the difference between the age groups was statistically significant(χ^2=11.577,P=0.018).Among the patients with HOX11L2 gene expression,10 patients(83.3%)had WBC count≤50×10^9/L,and 2 patients(16.7%)had WBC count>50×10^9/L,and the difference between the two groups was statistically significant(χ^2=5.469,P=0.019).In the FAB classification,75%of the patients with HOX11L2 gene expression were L1 type,and the difference was statistically significant compared with L2 and L3 groups(χ^2=8.766,P=0.008).Among the 34 patients who obtained follow-up data,the survival practice of HOX11L2 gene expression group was shorter than that of non expression group(median survival time was 8.0 months and 11.0 months respectively),and the difference between the two groups was statistically significant(P<0.05).Conclusion The results showed that HOX11L2 gene was mainly expressed in T-ALL patients,and it was mainly expressed in L1 children.The prognosis of HOX11L2 gene expression patients was poor,and the survival time was short.Clinically,the results of HOX11L2 gene detection combined with the results of conventional cytomorphology,genetics,fluorescence in situ hybridization and other technologies will be used for the differential diagnosis,typing,prognosis and microanalysis of acute lymphoblastic leukemia Detection of small residual diseases is of great significance.