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本研究旨在探讨慢性淋巴细胞白血病(CLL)患者鼠双微体4(MDM4)基因mRNA的表达情况及其在CLL预后中的意义。采用SYBR Green I荧光染料行实时定量逆转录PCR(qRT-PCR)方法检测66例CLL患者白血病细胞MDM4 mRNA的表达,以β-actin为内参照物,以2(-△Ct)方法计算MDM4的相对定量值,组间分析采用秩和检验。结果显示,66例CLL患者MDM4 mRNA相对表达水平的中位数为0.037098(0.088245-0.014875);具有P53基因缺失的CLL患者,其MDM4的表达明显高于无P53基因缺失的患者(0.13167 vs 0.030927)(p<0.001),具有P53基因突变的CLL患者MDM4 mRNA表达也明显高于无P53基因突变的患者(0.13167 vs0.03077)(p<0.001);此外,MDM4 mRNA的表达水平还与Binet分期(p=0.044)和ATM基因缺失(p=0.046)显著相关,但与血清乳酸脱氢酶(LDH)(p=0.216)、β2-微球蛋白(β2-MG)(p=0.314)、胸苷激酶(TK)1(p=0.300)、ZAP-70(p=0.559)、CD38(p=0.513)和免疫球蛋白重链可变区(IgVH)基因突变状态(p=0.333)无显著相关性。结论:MDM4的表达与P53基因异常关系密切,与Binet分期和ATM基因缺失相关,MDM4可能在CLL的预后中具有重要价值。
This study aimed to investigate the expression of MDM4 mRNA in chronic lymphocytic leukemia (CLL) patients and its significance in prognosis of CLL. The expression of MDM4 mRNA in leukemic cells from 66 patients with CLL was detected by real-time quantitative reverse transcription-PCR (qRT-PCR) with SYBR Green I fluorescent dye. Β-actin was used as an internal reference and the MDM4 Relative quantitative values, between groups analysis using rank sum test. The results showed that the median relative expression of MDM4 mRNA in 66 CLL patients was 0.037098 (0.088245-0.014875). The MDM4 expression in patients with CLL with P53 deletion was significantly higher than that in patients without P53 deletion (0.13167 vs 0.030927) (P <0.001). The expression of MDM4 mRNA in CLL patients with P53 gene mutation was also significantly higher than that in patients without P53 gene mutation (0.13167 vs 0.03077) (p <0.001). In addition, the expression of MDM4 mRNA was also correlated with Binet stage (p = 0.044) and ATM gene deletion (p = 0.046), but not with the levels of serum LDH (p = 0.216), β2-microglobulin There was no significant correlation between the mutation status of TK1 (p = 0.300), ZAP-70 (p = 0.559), CD38 (p = 0.513) and immunoglobulin heavy chain variable region (IgVH) . Conclusion: The expression of MDM4 is closely related to the abnormality of P53 gene, which is related to the Binet stage and the loss of ATM gene. MDM4 may have important value in the prognosis of CLL.