CAJ | 학술논문

目的研究Evi1基因在儿童急性淋巴细胞性白血病(acute lymphoblastic leukemia,ALL)的表达及免疫表型特点.方法采用逆转录-聚合酶链反应法和流式细胞仪检测2010年12月至2013年2月华中科技大学同济医学院附属协和医院儿科血液病区262例ALL EVI1基因的表达及免疫表型,比较EVI1基因表达阳性与表达阴性患儿的免疫表型及临床特征的差异.结果 262例ALL患儿有29例EVI1基因表达阳性.EVI1表达阳性与表达阴性的ALL患儿相比,EVI1阳性的ALL患儿初诊外周血白细胞计数增高,血小板下降,女性患儿所占比例高,强的松试验敏感者明显减少,第一疗程诱导缓解率明显降低(P＜0.05),而年龄、血红蛋白含量差异无统计学意义(P＞0.05).EVI1阳性的B系ALL高表达cCD79a、CD38、CD10、CD19、CD22,CD123、TDT、HLADR、CD34,T系ALL高表达CD2、CD3、CD4、CD5、CD7、CD8、CD38、cCD3.B系EVI1阳性组与阴性组相比,B系EVI1阳性组CD13、CD33、CD11b等髓系相关抗原表达增加,CD19、CD20、CD22等B细胞相关抗原表达减少(P＜0.05).结论 EVI1基因表达阳性的ALL是一种特殊类型的白血病亚型,近期预后差.B系EVI1阳性ALL患儿部分髓系相关抗原表达增加,部分B细胞相关抗原表达减少.
목적 연구Evi1기인재인동급성림파세포성백혈병(acute lymphoblastic leukemia,ALL)적표체급면역표형특점.방법 채용역전록-취합매련반응법화류식세포의검측2010년12월지2013년2월화중과기대학동제의학원부속협화의원인과혈액병구262례ALL EVI1기인적표체급면역표형,비교EVI1기인표체양성여표체음성환인적면역표형급림상특정적차이.결과 262례ALL환인유29례EVI1기인표체양성.EVI1표체양성여표체음성적ALL환인상비,EVI1양성적ALL환인초진외주혈백세포계수증고,혈소판하강,녀성환인소점비례고,강적송시험민감자명현감소,제일료정유도완해솔명현강저(P＜0.05),이년령、혈홍단백함량차이무통계학의의(P＞0.05).EVI1양성적B계ALL고표체cCD79a、CD38、CD10、CD19、CD22,CD123、TDT、HLADR、CD34,T계ALL고표체CD2、CD3、CD4、CD5、CD7、CD8、CD38、cCD3.B계EVI1양성조여음성조상비,B계EVI1양성조CD13、CD33、CD11b등수계상관항원표체증가,CD19、CD20、CD22등B세포상관항원표체감소(P＜0.05).결론 EVI1기인표체양성적ALL시일충특수류형적백혈병아형,근기예후차.B계EVI1양성ALL환인부분수계상관항원표체증가,부분B세포상관항원표체감소.
Objective To study the expression of Ecotropic viral integration site (EVI1) gene and clinical and immunophenotypic features of childhood acute lymphoblastic leukemia(ALL).Methods The expression of EVI1 gene and immunophenotyping of 262 children with acute lymphocytic leukemia in Department of Pediatric Hematology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from Dec.2010 to Feb.2013 were detected by RT-PCR and flow cytometry.Immunophenotypic and clinical features were compared between childhood with EVI1 gene positive and negetive.Results We identified 29 ALL with EVI1 gene positive among 262 childhood acute lymphocytic leukemia,the incidences positive expression was 11.07％.There was no signficant difference with respect to age,sex,hemoglobin between ALL with EVI1 positive and negetive respectively(P ＞ 0.05),but ALL with EVI1 positive had higher white blood cell count,lower platelet count in initial peripheral blood and more female children(P ＜ 0.05).The number of prednisone good-response and complete remission of the first course of treatment was significantly decreased in ALL with EVI1 positive(P ＜ 0.05).The expression of EVI1 gene was detected in both B-ALL and T-ALL respectively,and there was no signficant difference in expression incidence(P ＞0.05).cCD79a,CD38,CD10,CD19,CD22,CD123,TDT,HLADR,CD34 were highly expressed in B-ALL with EVI1 gene positive.CD2,CD3,CD4,CD5,CD7,CD8,CD38,cCD3 were highly expressed in T-ALL with EVI1 gene positive.The expression of CD19,CD20,CD22 in B-ALL with EVI1 gene positive was signficantly lower and CD13,CD1 1 b,CD33 was signficantly higher than B-ALL with EVI1 negative(P ＜ 0.05).Conclusion ALL with EVI1 gene positive is a relatively rare subtype of leukemia and the recent prognosis was poor.The expression of parts of myeloid lineage-associated antigens are signficantly higher,and parts of B lymphiod lineage-associated antigens are signficantly lower in childhood ALL with EVI1 gene positive.