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目的探讨急性淋巴细胞白血病(ALL)不同阶段、不同类型患儿血型糖蛋白C(GYPC)基因的表达水平及其与治疗反应和免疫分型的关系。方法研究对象为2005年1月至2005年11月哈尔滨市儿童医院血液科、哈尔滨医科大学一院儿科及哈尔滨市血液肿瘤研究所儿科住院的ALL患儿。应用半定量逆转录-聚合酶链反应(RT-PCR)的方法,检测ALL初治患儿、缓解患儿、难治患儿、复发患儿及正常对照儿童GYPC基因的表达;采用流式细胞术检测初治患儿的免疫表型,观察GYPC基因与免疫表型的关系。结果(1)初治患儿GYPC表达水平明显高于正常对照组(P<0.01)和完全缓解组(P<0.01);完全缓解后GYPC表达水平与对照组差异无统计学意义(P>0.05),复发患儿GYPC表达水平不仅高于正常对照组(P<0.01)和完全缓解组(P<0.01),也高于初治组(P<0.01);(2)38例初治患儿GYPC阳性24例,GYPC阴性14例,GYPC阳性患儿的完全缓解率与GYPC阴性患儿差异无统计学意义(分别为75.0%、92.9%,P>0.05),但完全缓解患儿治疗前GYPC表达水平低于未缓解患儿(P<0.05);(3)38例初治患儿中25例为B系淋巴细胞白血病(B-ALL),10例为T系淋巴细胞白血病(T-ALL),T-ALL的GYPC阳性率高于B-ALL(分别为90.0%、48.0%,P<0.05),且T-ALL的GYPC表达水平高于B-ALL(P<0.05)。结论GYPC的表达水平随儿童ALL的病情发展而变化,GYPC可以作为监测病情、判断疗效、预测复发、评估预后的一个新指标;GYPC高表达可能是儿童ALL的不利因素,GYPC高表达者疗效差,易复发;GYPC表达水平与免疫分型具有相关性,GYPC在T-ALL具有高表达,可能是T-ALL的缓解率低、预后差的原因之一。
Objective To investigate the expression of glycoprotein C (GYPC) gene in different types of children with acute lymphoblastic leukemia (ALL) and its relationship with therapeutic response and immune typing. Methods The subjects were ALL pediatric patients with pediatric department of Pediatrics, Harbin Children’s Hospital, Harbin First Hospital, Harbin Institute of Hematology and Oncology, Harbin, China from January 2005 to November 2005. The expression of GYPC gene in pediatric patients with ALL, refractory children, relapsed children and normal control children was detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). Flow cytometry To detect the immunophenotype of infants with newly diagnosed children and to observe the relationship between GYPC gene and immunophenotype. Results (1) The expression of GYPC in newly diagnosed children was significantly higher than that in normal control group (P <0.01) and complete remission group (P <0.01). There was no significant difference in GYPC expression level between control group and complete remission (P> 0.05 ). The expression of GYPC in relapsed children was higher than that in normal control group (P <0.01) and complete remission group (P <0.01), and also higher than that in initial treatment group (P <0.01). (2) GYPC positive in 24 cases, GYPC negative in 14 cases, GYPC positive children with complete remission rate and GYPC negative children was no significant difference (75.0%, 92.9%, P> 0.05), but complete remission in children with pretreatment GYPC (P <0.05); (3) 25 out of 38 newly diagnosed children were B lymphocytic leukemia (B-ALL), and 10 were T-lymphoblastic leukemia ). The positive rate of GYPC in T-ALL was higher than that in B-ALL (90.0% and 48.0%, respectively, P <0.05), and the expression of GYPC in T-ALL was higher than that in B-ALL. Conclusion The expression of GYPC changes with the development of ALL children. GYPC can be used as a new indicator to monitor the disease, judge the curative effect, predict the recurrence and evaluate the prognosis. GYPC expression may be the adverse factor of childhood ALL, and the effect of GYPC high expression is poor , And relapse easily. The expression level of GYPC is correlated with the immunophenotype. GYPC is highly expressed in T-ALL, which may be one of the reasons for the low response rate and poor prognosis of T-ALL.