【摘要】 目的研究急性淋巴细胞白血病(ALL)患者脑和急性白血病细胞胞浆(BAALC)基因的表达水平及其临床意义。方法 57例经细胞形态学、组织化学染色及流式细胞术免疫学分型确诊的ALL患者,其中男性35例,女性22例;中位年龄23(14～66)岁。FAB分型L1 9例,L2 45例,L3 3例。建立实时荧光定量PCR检测BAALC基因表达的技术,并定量检测57例初发ALL患者BAALC基因的表达水平及进一步分析其与临床疗效的关系。结果 57例初发ALL患者BAALC基因表达水平显著高于对照组。FAB各亚型中BAALC基因表达水平差异无统计学意义(P>0.05),BAALC基因表达水平的高低与初发ALL患者的免疫表型具有显著性相关,T-ALL患者和伴有髓系抗原表达ALL患者BAALC基因表达水平显著高于B-ALL(P<0.05)和不伴有髓系抗原表达ALL患者(P<0.01)。ALL中BAALC基因表达的水平与外周血白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(Plt)及骨髓白血病细胞比例无明显相关性(P>0.05)。BAALC基因高表达ALL患者的完全缓解率(73.3%)同低表达组(81.0%)比较差异无统计学意义(P>0.05),但BAALC基因高表达患者1年复发率(81.8%)明显高于低表达组(44.1%)(P<0.05)。结论 BAALC基因高表达提示可能是ALL患者一个不良预后因素,检测ALL患者BAALC基因表达水平可能有助于指导治疗。更多还原

【Abstract】 Objective To investigate brain and acute leukemia cytoplasmic(BAALC) gene expression in patients with de novo acute lymphoblastic leukemia(ALL) and its clinical significance.Methods The BAALC expression was determined by real-time quantitative polymerase chain reaction(RQ-PCR) in 57 de novo ALL patients,male 35,female 22,aged 14-66 years old,median age 23 years old.FAB classifications were L1(n=9),L2(n=45),L3(n=3),and further analyzed the relationship with clinical efficacy.Results The expression of BAALC gene was significantly higher in ALL group than in control group(P<0.05).There were no statistical differences of BAALC gene expression levels in FAB subgroups but in immunophenotyping groups,BAALC gene expression levels of T-ALL patients were significantly higher than that of B-ALL(P<0.05),high BAALC expression was highly associated with myeloid antigen expression(P<0.01).The expression levels of BAALC gene were not correlated with peripheral white blood cell(WBC) counts,hemoglobin level,platelet counts and percentage of bone marrow blast cell at presentation(P>0.05).There was no significant difference of complete remission(CR) rates between high BAALC expression(73.3%) and low BAALC expression(81.0 %)(P>0.05).High BAALC expressers showed significance higher 1-year cumulative relapse rates(81.8%) compared with low BAALC expression(44.1 %)(P<0.05).Conclusion High expression of BAALC gene may define as an risk factor in ALL patients and predicts an adverse prognosis.Therefore the expression of BAALC may provides useful information for clinical decision.更多还原