CAJ | 학술논문

目的探索BCL2L12基因在急性髓系白血病(acute myeloid leukemia,AML)细胞中的表达水平及其临床意义.方法用实时定量PCR检测134例初发AML患者白血病细胞中BCL2L 12基因的表达水平,收集临床和实验室资料进行统计分析.结果在134例初发AML患者和49名正常对照中均检测到BCL2L 12基因的表达.初发AML患者表达中位数为0.1029(0.0119～26.4090),显著低于正常对照[中位数0.2677(0.0173～1.2858),P＜0.01].BCL2L12基因低表达者FLT3-ITD的突变率(27％)高于高表达者(5％,P=0.036).复发难治者BCL2L12基因的表达水平[(中位数0.0873(0.0119～9.2000)]显著低于初发组[中位数0.1359(0.0286～26.4091),P=0.014].在随访的114例患者中,BCL2L12基因高表达组与低表达组的总体生存时间(overall survival,OS)差异无统计学意义(P＞0.05),但在核型正常的AML患者中,BCL2L12基因低表达组的OS显著短于高表达组(P=0.037).结论 BCL2L12基因在初发AML患者中普遍低表达.低表达者FLT3-ITD的突变率较高且多为难治型AML.核型为正常的患者中,BCL2L12基因低表达者OS短于高表达者.BCL2L12基因低表达可能作为核型正常的AML患者预后不良的指标.
목적 탐색BCL2L12기인재급성수계백혈병(acute myeloid leukemia,AML)세포중적표체수평급기림상의의.방법 용실시정량PCR검측134례초발AML환자백혈병세포중BCL2L 12기인적표체수평,수집림상화실험실자료진행통계분석.결과 재134례초발AML환자화49명정상대조중균검측도BCL2L 12기인적표체.초발AML환자표체중위수위0.1029(0.0119～26.4090),현저저우정상대조[중위수0.2677(0.0173～1.2858),P＜0.01].BCL2L12기인저표체자FLT3-ITD적돌변솔(27％)고우고표체자(5％,P=0.036).복발난치자BCL2L12기인적표체수평[(중위수0.0873(0.0119～9.2000)]현저저우초발조[중위수0.1359(0.0286～26.4091),P=0.014].재수방적114례환자중,BCL2L12기인고표체조여저표체조적총체생존시간(overall survival,OS)차이무통계학의의(P＞0.05),단재핵형정상적AML환자중,BCL2L12기인저표체조적OS현저단우고표체조(P=0.037).결론 BCL2L12기인재초발AML환자중보편저표체.저표체자FLT3-ITD적돌변솔교고차다위난치형AML.핵형위정상적환자중,BCL2L12기인저표체자OS단우고표체자.BCL2L12기인저표체가능작위핵형정상적AML환자예후불량적지표.
Objective To explore the expression of BCL2L12 gene and its clinical significance for de novo acute myeloid leukemia (AML).Method Real-time quantitative PCR (RQ-PCR) was employed to measure the expression of BCL2L12 gene in 134 patients with de novo AML.The results were correlated with clinical features of patients.Results BCL2L12 gene transcript was determined for 134 AML patients and 49 healthy controls,with the median levels measured 0.1029 (0.0119-26.4090) and 0.2677 (0.0173-1.2858),respectively.There was a significant difference in the strength of BCL2L12 gene expression between patients and normal controls (P＜0.01).Those with lower BCL2L12 expression levels had a higher FLT3-ITD mutation rate compared with those with higher levels (27％ vs.5％,P=0.036).Relapsed or refractory AML patients had lower expression compared with newly diagnosed patients (0.0873 vs.0.1359,P=0.014).There was no difference in overall survival (OS) between patients with higher and lower expression levels.However,for AML patients with a normal karyotype,the OS for those with lower expression was significant shorter (P=0.037).Conclusion De novo AML patients have a lower level of BCL2L12 gene expression.AML patients with lower BCL2L12 expression have a higher FLT3-ITD mutation rate,and most of them are relapse or refractory patients.In addition,among patients with a normal karyotype,those with a lower BCL2L12 expression have a shorter OS.Therefore,expression of the BCL2L12 gene may be used as a prognostic marker for AML patients with a normal karyotype.