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目的 探讨Evi1基因表达在慢性粒细胞白血病 (慢粒 )急性变中的意义。方法 应用半定量RT -PCR方法检测了HEL白血病细胞系、87例慢粒患者 (慢性期 5 8例 ,加速期 4例 ,急性变期 2 5例 )及 10名正常对照的Evi1基因的表达。结果 10名正常对照骨髓单个核细胞中未测到Evi1mRNA ;HEL细胞系Evi1阳性 ;87例慢粒中 ,慢性期组、加速期组、急性变组、急性髓性变组Evi1基因表达的阳性率分别为 3 .5 % (2 5 8)、5 0 .0 % (2 4)、48 0 % (12 2 5 )、66.7% (12 18) ) ;但加速期及急性变组的Evi1基因表达率高于慢性期组 (P <0 .0 1) ,而加速期组和急性变组的阳性率无显著性差异 (P =1.0 0 ) ,急性髓性变组的阳性率高于急淋变组 ,差异显著 (P <0 .0 1) ;慢性期组的阳性率较正常对照相比差异无显著性 (P =1.0 0 ) ;Evi1基因阳性表达与慢粒临床分期、急性变分型及预后相关 ,而急性变期Evi1阳性表达与年龄、性别、外周血象、bcr abl融合基因无关。结论 Evi1基因是预测慢粒患者发生急性变的一个有用的基因标志 ,可看做是一个由慢性期向急性期转化的信号 ,并对慢粒急性髓性变或急淋变有鉴别诊断意义
Objective To investigate the significance of Evi1 gene expression in the acute change of chronic myeloid leukemia (CML). Methods Semi-quantitative RT-PCR was used to detect the expression of Evi1 gene in HEL leukemia cell line, 87 patients with chronic granulocytes (58 in chronic phase, 4 in accelerated phase and 25 in acute phase) and 10 normal controls. Results Evi1 mRNA was not detected in 10 normal control bone marrow mononuclear cells; Evi1 positive in HEL cell line; the positive rate of Evi1 gene expression in 87 chronic granulocytes, chronic phase group, accelerated phase group, acute change group and acute myeloidosis group Were 3.5% (25.8%), 50.0% (2 4), 48% (12 2 5), 66.7% (12 18), respectively; however, the Evi1 gene expression (P <0.01), but there was no significant difference between accelerated group and acute group (P = 1.0 0). The positive rate of acute myeloid group was higher than that of acute lymphoid group Group, the difference was significant (P <0.01); The positive rate of chronic phase group was no significant difference compared with the normal control group (P = 1.0 0); The positive expression of Evi1 gene and the clinical stage, Prognosis, while the acute phase Evi1 positive expression and age, gender, peripheral blood, bcr abl fusion gene has nothing to do. Conclusions Evi1 gene is a useful genetic marker for predicting the acute changes in CML patients. It can be regarded as a signal transformed from chronic phase to acute phase, and has differential diagnostic significance for acute myelogenous leukemia or acute lymphoid lesions