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目的:探讨抗凋亡基因XIAP在慢性淋巴细胞白血病中的表达,分析其与IgVH突变、CD38等临床重要预后指标的相关性。方法:采用SyberGreen法实时定量PCR(qPCR)技术检测37例CLL患者肿瘤细胞中抗凋亡基因XIAP的mRNA表达水平,同时利用28例年龄匹配的正常人作为阴性对照,分析其临床意义。结果:经过qPCR检测正常对照组XIAP表达中位数为0.04040(95%CI:0.01610～0.06471),CLL组XIAP表达为0.07502(0.04383～0.1062),两者具有显著统计学差异(P=0.0025);亚组分析发现耐药组XIAP表达为0.08295(0.02575～0.1402),药物敏感组为0.07020(0.03042～0.1100),耐药组XIAP表达高于药物敏感组,但是未达到统计学差异(P=0.3978)。进一步分析显示XIAP mRNA表达水平和IgVH突变状态和CD38表达相关:IgVH无突变和CD38高表达的CLL患者XIAP表达显著升高(P值分别为0.0265和0.0388)。结论:利用qPCR技术发现抗凋亡基因XIAP在CLL患者中存在异常高表达,耐药组有高于药物敏感组的趋势,并且与CLL临床预后因素IgVH突变状态和CD38表达密切相关。
OBJECTIVE: To investigate the expression of antiapoptotic gene XIAP in chronic lymphocytic leukemia and analyze its correlation with IgVH mutation and CD38 clinical prognostic indicators. Methods: The mRNA expression levels of XIAP in anti-apoptotic gene of 37 CLL patients were detected by SyberGreen quantitative real-time PCR (qPCR). Meanwhile, 28 age-matched normal subjects were used as negative controls to analyze the clinical significance. Results: The median of XIAP expression in control group was 0.04040 (95% CI: 0.01610-0.06471) by qPCR and 0.07502 (0.04383-0.1062) in CLL group, with significant difference (P = 0.0025). In subgroup analysis, XIAP expression was 0.08295 (0.02575-0.1402) in drug-resistant group and 0.07020 (0.03042-0.11100) in drug-sensitive group. XIAP expression in drug-resistant group was higher than that in drug-sensitive group (P = 0.3978) . Further analysis showed that the level of XIAP mRNA expression was correlated with the IgVH mutation status and the expression of CD38. XIAP expression was significantly increased in patients with CLL without mutations of IgVH and high expression of CD38 (P values were 0.0265 and 0.0388, respectively). Conclusions: The expression of antiapoptotic gene XIAP in CLL patients was found to be abnormally high expression by qPCR technique. The resistance of drug-resistant group was higher than that of drug-sensitive group, and closely correlated with the IgVH mutation status and CD38 expression in clinical prognostic factors of CLL.