FLT3基因表达在急性髓系白血病中的临床意义

来源 :四川大学学报(医学版) | 被引量 : 0次 | 上传用户:comeonlinli
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
目的研究急性髓系白血病(AML)患者骨髓中FMS样酪氨酸激酶3基因(FLT3)表达水平与FLT3基因内部串联重突变(FLT3-ITD突变)、临床表现和疾病预后的相关性及意义。方法采用荧光定量PCR法检测128例AML患者初诊时骨髓标本中FLT3基因表达水平,以FLT3基因表达量<35%作为低表达组,≥35%作为高表达组,并探讨不同FLT3基因表达水平的FLT3-ITD突变、临床症状、实验室检查结果及疾病预后,采用多因素logistic回归分析FLT3基因高表达的影响因素,采用单因素Cox回归和生存曲线进行生存分析。结果剔除1例不合格的M2患者RNA样本,最终纳入127例进行分析。AML患者初诊时FLT3表达量为0.01~180.68(均值14.65)。FLT3基因表达水平在WHO的AML分型中M1最高,M6最低,但各亚型间差异不具有统计学意义。FLT3基因高表达组AML患者外周血白细胞计数(WBC)较低表达组高(P<0.01),且高表达组患者更容易发生贫血及发热临床症状(P<0.05),多因素logistic回归发现,FLT3基因高表达的可能相关因素为WBC〔回归系数(B)=1.508,比值比(OR)=4.518,95%可信区间(95%CI):1.465~13.390,P=0.009〕及贫血(B=2.142,OR=8.513,95%CI:3.201~22.644,P<0.001)。FLT3基因低表达组AML患者完全缓解率(CR)为81.82%(36/44),高于FLT3基因高表达组38.55%(32/83),(P<0.05)。生存曲线显示,FLT3基因高表达组患者生存时间较低表达组短(P<0.05)。Cox回归显示,FLT3基因表达高水平患者死亡风险是FLT3基因表达低水平者的3.810倍(B=1.338,相对危险度3.810,95%CI:1.820~7.947,P<0.001)。高表达组总生存率为56.63%,低表达组为70.45%,两组间差异有统计学意义(P<0.05)。结论 FLT3基因高表达可能与AML患者WBC及贫血症状有关。FLT3基因高表达是AML患者预后不良的指标。 Objective To study the correlation between the expression of FLT3 gene and the FLT3-FLT3-ITD mutation, clinical manifestations and disease prognosis in patients with acute myeloid leukemia (AML). Methods Fluorescence quantitative PCR was used to detect FLT3 gene expression in bone marrow samples from 128 AML patients newly diagnosed. FLT3 gene expression levels were <35% low expression group and> 35% high expression group, and the expression levels of different FLT3 genes FLT3-ITD mutation, clinical symptoms, laboratory test results and disease prognosis. The multivariate logistic regression analysis was used to analyze the influencing factors of FLT3 gene expression. Survival analysis was performed by single-factor Cox regression and survival curves. Results One patient with unqualified M2 patients was excluded from the RNA samples, and 127 patients were finally included in the analysis. FLT3 expression in AML patients was 0.01 ~ 180.68 (mean 14.65). FLT3 gene expression levels in the WHO AML M1 the highest, M6 the lowest, but the differences between the subtypes was not statistically significant. Patients with high FLT3 gene expression in AML patients had higher WBC (P <0.01), and patients with high expression of FLT3 gene were more likely to develop clinical symptoms of anemia and fever (P <0.05). Multivariate logistic regression analysis showed that, The possible related factors for the high expression of FLT3 gene were WBC (regression coefficient = 1.508, OR = 4.518, 95% CI: 1.465-13.390, P = 0.009) and anemia = 2.142, OR = 8.513, 95% CI: 3.201 ~ 22.644, P <0.001). The complete remission rate (CR) was 81.82% (36/44) in FLT3 low expression group and 38.55% (32/83) in FLT3 high expression group (P <0.05). Survival curves showed that patients with high FLT3 gene expression had shorter survival time (P <0.05). Cox regression showed that the risk of death from high FLT3 gene expression was 3.810 times lower than that of FLT3 (B = 1.338, relative risk 3.810, 95% CI 1.820 to 7.947, P <0.001). The overall survival rate was 56.63% in high expression group and 70.45% in low expression group, with significant difference between the two groups (P <0.05). Conclusion The high expression of FLT3 gene may be related to WBC and anemia in AML patients. FLT3 gene overexpression is an indicator of poor prognosis in patients with AML.
其他文献
目的:探讨髓芯减压、CPC/丹参缓释系统回植治疗非创伤性股骨头缺血性坏死的作用机理,评价其临床疗效。 方法:利用大肠杆菌内毒素(LPS)加大剂量甲基强的松龙(MP)造成30只纯种新西
本文在国内首次从中医理论和实验研究两方面对血管性痴呆(VD)从肺论治的可行性进行初步系统探讨,为寻求VD新的治疗方法提供了重要依据。一、理论探讨 1.理论基础:(1)肺与心
忠诚折扣是一种高效的营销手段,一般而言,折扣行为能够带给消费者低价优惠,增加经营者销售数量,刺激相关市场同类经营者降价优惠或者提高产品竞争力,从而提高经济效益.但是当
雅典奥运会结束后,全球的目光已经逐渐向北京转移,今后3 年半的时间是北京筹办奥运会的关键时期。根据北京市委、市政府和奥组委的部署,北京日报在今年专门开辟了大量专版进
本文通过对荣华二采区10
期刊
法人人格否认制度是对法人独立地位和股东有限责任的例外和补充,该制度可以有效地兼顾债权人利益保障和股东有限责任平衡的价值取向和原则.然而司法实践中基于法院对否认法人
从2004年的《缺陷汽车产品召回管理规定》出台,到后来《缺陷汽车产品召回管理条例》(正文简称《条例》)的实施,中国缺陷汽车产品召回制度已经历了十余年的实践.在市场经济环
在国内互联网行业竞争白热化的状况下,互联网公司以商业模式为基础,吸引用户并实现盈利已成为普遍现象,但在实际市场竞争中,竞争者的竞争行为往往容易造成对他人商业模式的侵
目的通过动物实验研究复方蜥蜴散(以下简称:FFXY)对溃疡性结肠炎(UC)模型大鼠组织中PPAR-γ、NF-κB p65及i NOS表达水平,血清中白介素-6含量变化的影响,探讨FFXY治疗UC可能的作用机制,为临床应用复方蜥蜴散诊疗UC提供实验依据。方法84只无特定病原体级(SPF级)SD大鼠,4-6周龄,体质量(190±20)g,大鼠自购进适应性喂养1周后,随机分成空白对照组、模型组、柳氮黄嘧
当前,在全球毒品犯罪日益恶化的环境下,我国同毒品犯罪的斗争虽趋势向好,但形势依然严峻.秘密侦查在缉毒部门同毒品犯罪的斗争中无疑扮演了不可或缺的角色,可以说是战胜毒品