Evi1基因表达在慢性粒细胞白血病急性变中的意义

Expression of Evi1gene in the evolution of chronic myelogenous leukemia to blast crisis

目的 探讨Evi1基因表达在慢性粒细胞白血病 (慢粒 )急性变中的意义。方法 应用半定量RT -PCR方法检测了HEL白血病细胞系、87例慢粒患者 (慢性期 5 8例 ,加速期 4例 ,急性变期 2 5例 )及 10名正常对照的Evi1基因的表达。结果 10名正常对照骨髓单个核细胞中未测到Evi1mRNA ;HEL细胞系Evi1阳性 ;87例慢粒中 ,慢性期组、加速期组、急性变组、急性髓性变组Evi1基因表达的阳性率分别为 3 .5 % (2 5 8)、5 0 .0 % (2 4)、48 0 % (12 2 5 )、66.7% (12 18) ) ;但加速期及急性变组的Evi1基因表达率高于慢性期组 (P <0 .0 1) ,而加速期组和急性变组的阳性率无显著性差异 (P =1.0 0 ) ,急性髓性变组的阳性率高于急淋变组 ,差异显著 (P <0 .0 1) ;慢性期组的阳性率较正常对照相比差异无显著性 (P =1.0 0 ) ;Evi1基因阳性表达与慢粒临床分期、急性变分型及预后相关 ,而急性变期Evi1阳性表达与年龄、性别、外周血象、bcr abl融合基因无关。结论 Evi1基因是预测慢粒患者发生急性变的一个有用的基因标志 ,可看做是一个由慢性期向急性期转化的信号 。

Objective To investigate the significance of the expression of Evi1 gene in chronic myelogenous leukemia (CML) blast crisis (BC).?Methods The expression of Evi1 mRNA was detected in HEL leukemia cell line, 87 CML patients (58 chronic phase, 4 accelerated phase and 25 blast crisis) and 10 healthy subjects by semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR).?Results Evi1 mRNA was negative in the 10 healthy subjects, and was positive in 2 of 58 (3.45%) CML-chronic phase(CP), 2 of 4 CML-accelerated phase (AP), 12 of 25 (48%) CML-blast crisis (BC), 12 of 18 (66.7%) CML in myeloid crisis (BC/M), and 0 of 5 (0%) CML in lymphoid crisis (BC/L). The positive rate of Evi1 expression was higher in CML-BC and CML-AP than in CML-CP ( P <0.01), and was markedly higher in CML-BC/M than in CML-BC/L ( P =0.008). The expression of Evi1 gene was related to the phase, type and prognosis of CML, but in CML-BC, it showed no relations to the age, sex, peripheral blood picture and bcr/abl fusion gene.?Conclusion The increased expression of Evi1 gene may be a useful genetic marker to predict the onset of BC in CML and help differentiate BC/M from BC/L.