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HOXB4、PRDM16及HOXA9基因在急性髓系白血病中的表达及其临床意义
Expression of HOXB4、PRDM16 And HOXA9 in Patients with Acute Myeloid Leukemia And Its Clinical Significance
【作者】 李琳；
【导师】 赵春亭；
【作者基本信息】 青岛大学 ， 内科学（血液病学）， 2016， 硕士
【摘要】 目的本实验旨在检测HOXB4、PRDM16、HOXA9基因在急性髓系白血病(AML)患者骨髓中的表达水平,探讨其临床意义。方法采用实时荧光定量PCR方法,检测了40例初治或复发AML、9例完全缓解和19例对照组(非恶性血液病患者及健康供者)骨髓细胞HOXB4、PRDM16、HOXA9 m RNA表达水平,分析其与疾病特征、临床疗效之间关系。结果初治或复发AML患者骨髓细胞中HOXB4、PRDM16、HOXA9 m RNA表达水平均明显高于非恶性血液病患者(P<0.05);初治或复发AML患者HOXB4基因表达水平与骨髓白血病细胞比例成正相关(r=0.39),HOXB4、PRDM16、HOXA9基因的表达水平两两之间具有相关性;AML不同病程阶段(初诊、复发、缓解)HOXB4、PRDM16基因表达水平差异具有统计学意义;按预后危险度分层将初治及复发AML患者分为高、中、低危3组,3组之间HOXB4、PRDM16、HOXA9表达水平的差异无统计学意义;经2疗程正规化疗,缓解组(CR/PR)患者治疗前的3个基因表达水平均低于未缓解组治疗前水平(P<0.05);3个基因低表达组缓解率均高于高表达组(P<0.05)。结论:HOXB4、PRDM16、HOXA9基因表达水平和AML患者肿瘤负荷、疗效和预后存在一定的关系。在初治和复发的AML患者骨髓细胞高表达,缓解后其表达水平下降,表达高者易出现化疗效果差,缓解率低。结论HOXB4、PRDM16、HOXA9基因表达水平和AML患者肿瘤负荷、疗效和预后存在一定的关系。在初治和复发的AML患者骨髓细胞高表达,缓解后其表达水平下降,表达高者易出现化疗效果差,缓解率低。
【Abstract】 Objective : To investigate HOXB4,PRDM16 and HOXA9 gene expression in patients with acute myeloid leukemia(AML)and its clinical significance.Methods: Real-time quantitative PCR(RT-q PCR) with SYBR Green assay was used to detect the expression of HOXB4 、 PRDM16 、 HOXA9 gene in AML patients(40 cases),patients with complete remission(9 cases) and patients with non-malignant hematologic diseases(10 cases).The relationship between HOXB4,PRDM16,HOXA9 gene expression levels and clinical features was investigated by statistical analysis.Results: The expression of HOXB4,PRDM16,HOXA9 gene were significantly higher in AML patients than that in the controls(P<0.05). It were observed that the expression of HOXB4 correlate with leukemic blasts in bone marrow, and these three genes correlate with each other. There was statistically significant differences among gene expressions in different course phase(newly diagnosed, relapse, remission).No correlation was observed between expression levels of HOXB4、PRDM16、HOXA9 and chromosome risk status. It was noticed that expression levels of HOXB4,PRDM16,HOXA9 genes were lower in patients who achieved remission after two courses of chemotherapy than the other. And high expression group of each gene had a lower remission rate than that in the low expression group.Conclusion: There are somewhat correlation between the expression level of HOXB4,PRDM16,HOXA9 genes and leukemic blasts and curative effect. The expression of HOXB4,PRDM16,HOXA9 genes is higher in acute leukemia patients,and lower in patients acquired CR/PR.High expression of HOXB4,PRDM16,HOXA9 genes might predict an adverse prognosis.