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目的探讨初治急性髓系白血病(AML)成年患者I-mfa基因表达水平及其与疾病发展、预后的临床意义。方法选择110例AML患者,其中男性66例,女性44例;年龄14~77岁,中位年龄32岁。通过实时荧光定量聚合酶链反应(realtime PCR)方法检测初治AML成年患者骨髓标本I-mfa基因的表达水平,分析其与疾病特征、临床疗效间的关系。结果以110例初治AML成年患者I-mfa基因表达量的中位数为分界点,将患者分为I-mfa基因低表达组66例和高表达组44例。在初治AML成年患者中,I-mfa基因表达水平在年龄、性别、FAB分型、外周血象、原始细胞比例、遗传学危险度分层及CD34表达间差异无统计学意义(P>0.05)。I-mfa基因低表达组完全缓解(CR)率高于高表达组,差异有统计学意义(81.8%vs 59.1%,P=0.032)。I-mfa基因低表达组中位生存时间622 d(17~1 787 d),而高表达组患者中位生存时间418 d(14~1 806 d),差异有统计学意义(P=0.021)。结论 I-mfa基因低表达组初治AML成年患者CR率显著高于高表达组,其中位生存时间亦较高表达组长,提示I-mfa基因高表达AML成年患者可能预后较差,值得进一步研究。
Objective To investigate the expression of I-mfa in adult patients with acute myeloid leukemia (AML) and its clinical significance with disease development and prognosis. Methods A total of 110 patients with AML were selected, including 66 males and 44 females, aged 14-77 years with a median age of 32 years. Real-time PCR was used to detect the expression of I-mfa gene in the bone marrow of the newly diagnosed AML patients. The relationship between the I-mfa gene and the disease characteristics and clinical efficacy was analyzed. Results The median of I-mfa gene expression in 110 newly diagnosed AML adult patients was used as the cut-off point. The patients were divided into 66 cases with low I-mfa gene expression group and 44 cases with high expression group. In newly diagnosed AML adult patients, there was no significant difference in the expression of I-mfa gene between age, sex, FAB typing, peripheral blood count, blasts, stratification of genetic risk and CD34 expression (P> 0.05) . The rate of complete remission (CR) in I-mfa low expression group was higher than that in high expression group, the difference was statistically significant (81.8% vs 59.1%, P = 0.032). The median survival time of I-mfa gene expression group was 622 days (17-1787 days), while the median survival time was 418 days (14-1806 days) in the high-expression group, with significant difference (P = 0.021) . Conclusion The CR rate of newly diagnosed AML patients with low expression of I-mfa gene is significantly higher than that of high-expression group, and the median survival time is also higher, suggesting that IMLA-overexpressing AML patients may have worse prognosis and may be worth further the study.