T细胞免疫球蛋白黏蛋白分子3与半乳糖凝集素9在急性髓系白血病中的表达及其临床意义

Expression and clinical significance of immunoglobulin mucin 3 and galactoagglutinin 9 in T cells of acute myeloid leukemia

目的 研究T细胞免疫球蛋白黏蛋白分子3(Tim-3)与半乳糖凝集素9(Gal-9)在急性髓系白血病(AML)中的表达及其临床意义。方法 回顾性研究2021年9月至2023年11月佳木斯大学附属第一医院收治的80例AML患者的临床资料,选取同期在同院健康体检的受检者50名作为对照组。分析并对比两组研究对象的Tim-3、Gal-9 mRNA表达,分析不同临床病理特征(性别、初次化疗效果、年龄、白细胞计数、血小板计数、中枢神经侵犯)AML患者的Tim-3、Gal-9 mRNA表达以及不同表达水平下的AML患者的生存率。结果 研究组患者治疗前与治疗后的Tim-3 mRNA表达分别为2.81±0.47、1.67±0.34,Gal-9 mRNA表达分别为9.22±0.55、7.88±0.44,均明显高于对照组(0.47±0.06、0.92±0.18),差异均有统计学意义(P<0.05)。不同性别、初次化疗效果、年龄、白细胞计数、血小板计数的AML患者,Tim-3、Gal-9 mRNA表达水平比较,差异均无统计学意义(P>0.05);中枢神经侵犯患者的Tim-3、Gal-9 mRNA表达分别为2.91±0.55、9.34±0.49,明显高于无中枢神经侵犯患者(2.64±0.46、8.87±0.55),差异均有统计学意义(P<0.05)。AML患者治疗前Tim-3 mRNA高表达组2年生存率为77.27%,明显低于低表达组(30.56%),差异有统计学意义(P<0.05)。Gal-9 mRNA高表达组2年生存率70.59%,明显低于低表达组(45.65%),差异有统计学意义(P<0.05)。结论 AML患者的Tim-3以及配体Gal-9表达均明显升高,且二者的表达水平与患者生存率明显相关,可以用作AML临床预后评估的重要指标。

Objective To investigate the expression and clinical significance of immunoglobulin mucin molecule 3(Tim-3)and galactoagglutinin 9(Gal-9)in T cells of acute myeloid leukemia(AML).Methods The clinical data of 80 patients with acute myeloid leukemia admitted to the First Affiliated Hospital of Jiamusi University from September 2021 to November 2023 were retrospectively studied,and 50 healthy subjects in the same hospital during the same period were selected as the control group.The expressions of Tim-3 and Gal-9 mRNA in the two groups were analyzed and compared,and the expressions of Tim-3 and Gal-9 mRNA in AML patients with different clinicopathological characteristics and the survival rate of AML patients with different expression levels were analyzed.Results The Tim-3 mRNA expression before and after treatment in the study group was 2.81±0.47 and 1.67±0.34,respectively,the Gal-9 mRNA expression was 9.22±0.55 and 7.88±0.44,respectively,which were significantly higher than those in the control group(0.47±0.06,0.92±0.18),and the differences were statistically significant(P<0.05).There were no statistically significant differences in the expression levels of Tim-3 and Gal-9 mRNA among AML patients of different genders,initial chemotherapy efficacy,age,white blood cell count,and platelet count(P>0.05);the mRNA expressions of Tim-3 and Gal-9 in patients with CNS invasion were 2.91±0.55,9.34±0.49,respectively,which were significantly higher than those in patients without CNS invasion(2.64±0.46,8.87±0.55),and the differences were statistically significant(P<0.05).The 2-year survival rate of AML patients with high Tim-3 mRNA expression before treatment was 77.27%,which was significantly lower than that of patients with low TIM-3 mrna expression(30.56%),and the difference was statistically significant(P<0.05).The 2-year survival rate of the high expression group of Gal-9 mRNA was 70.59%,which was significantly lower than that of the low expression group(45.65%),and the difference was statistically significant(P<0.05).Conclusion The expression of Tim-3 and Gal-9 in patients with AML is significantly increased,and the expression levels of both are significantly correlated with the survival rate of patients,and can be used as an important indicator for the clinical prognosis assessment of AML.