分化抑制因子nm23基因在急性白血病细胞中的表达及临床意义

Expression of nm23 genes in acute myeloid leukemia and its clinical significance

目的 探讨分化抑制因子nm2 3在急性白血病细胞中的表达水平及临床意义。方法 应用RT PCR半定量分析 34例初诊急性白血病 [2 2例急性髓系白血病 (AML) ,12例急性淋巴细胞白血病 (ALL) ],9例临床完全缓解AML(AML CR) ,4例慢性粒细胞白血病 (CML)患者的骨髓标本中nm2 3 H1、nm2 3 H2的mRNA表达水平 ,并分析了其与一些临床指标的关系。结果 nm2 3 H1基因在急性白血病 ,尤其是粒 单核细胞及单核细胞白血病 (M4 、M5)中的表达水平明显增高 ;经化疗完全缓解后的AML患者nm2 3基因表达显著低于初诊AML患者 ;在AML中 ,nm2 3 H1的高表达与外周血白细胞计数、乳酸脱氢酶、CD7及髓外浸润等预后较差指标呈正相关性 ,而与特征性染色体异常如t(8;2 1)和t(15 ;17)呈负相关性。结论 nm2 3 H1基因在急性白血病特别是粒 单核细胞白血病 (M4 、M5)中表达较正常人明显增高 。

Objective To explore nm23 gene mRNA expression and its clinical significance in acute leukemias (AML). Methods The levels of nm23 H1 and nm23 H2 transcripts in 22 patients with acute myeloid leukemia(AML),9 AML in complete remission(AML CR),12 acute lymphoblastic leukemia (ALL) and 4 chronic myeloid leukemia in chronic phase (CML CP) were assayed by reverse transcriptase polymerase chain reaction (RT PCR). Results The expression of nm23 H1 in AL especially in AML M4 and AML M5 was significantly higher than that in normal blood cells. An analysis of correlation between nm23 expression and clinicopathological parameters showed that increased nm23 H1 mRNA levels were associated with some poor prognostic factors such as extramedullary infiltration, high white blood cell count (WBC), high lactate dehydrogenase (LDH) activity and high CD 7 expression, while inversely correlated with t(8;21) and t(15;17) which had a good prognostic effect. The expression of nm23 H1 in AML patients in CR was significantly decreased compared with those untreated. Conclusion nm23 H1 was overexpressed in AL, especially in AML M4 and AML M5. High expression of nm23 H1 may be a poor prognostic factor.