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目的探讨nm23H1基因在儿童急性白血病(AcuteLeakemia,AL)细胞中的表达及临床意义。方法采用半定量逆转录聚合酶链反应,RTPCR检测67例次AL儿童患者,ALL31例,AML14例,AL(CR)18例,复发4例及10例ITP患儿骨髓细胞nm23H1表达,将nm23H1/GAPDH≥0.5定为(+)。结果儿童ALL、AML中nm23H1基因表达显著高于正常对照组(P<0.001),AML中M4+M5组的nm23H1表达程度较M2+M3组高(P<0.05)。经化疗在CR后儿童AL患者表达显著低于初诊患儿,复发病人再度升高且阳性表达程度高的易复发。nm23H1基因表达程度与外周血白细胞计数及乳酸脱氢酶值呈正相关(r=0.472P<0.01;r=0.403P<0.05)。CD7+患者nm23H1表达高CD7患者(P<0.05)而与HLADR,CD34阳性或阴性表达无显著性。结论nm23H1可能在儿童AL中发挥一定作用,尤其在粒单或单核细胞性白血病中更具重要作用,还与儿童AL的病情活动有关,与白血病细胞处的分化阶段无明显关系。nm23H1基因的表达是儿童AL重要的预后因素。
Objective To investigate the expression of nm23H1 gene in children with acute leukemia (AL) and its clinical significance. Methods 67 cases of children with AL, 31 cases of ALL, 14 cases of AML, 18 cases of AL (CR), 4 cases of relapse and 10 cases of ITP were used to detect the expression of nm23H1 in 67 cases of children with AL by semi-quantitative reverse transcription polymerase chain reaction. The nm23H1 / GAPDH≥0.5 is defined as (+). Results The expression of nm23H1 in children with ALL and AML was significantly higher than that in normal controls (P <0.001). The expression of nm23H1 in M4 + M5 group was higher than that in M2 + M3 group (P <0.05). After chemotherapy, the expression of AL in children with CR was significantly lower than that in newly diagnosed children, and relapsed patients with relapse again and the positive expression was high. The expression of nm23H1 was positively correlated with peripheral blood leukocyte count and lactate dehydrogenase (r = 0.472P <0.01; r = 0.403P <0.05). The expression of nm23H1 in CD7 + patients with high CD7 (P <0.05) but not with HLADR and CD34 was not significant. Conclusion nm23H1 may play a role in children with AL, especially in the mononucleosis or monocytic leukemia. It is also related to the AL activity in children and has no relationship with the differentiation stage of leukemia cells. The expression of nm23H1 gene is an important prognostic factor of AL in children.