CAJ | 학술논문

目的本研究旨在探讨初诊急性B淋巴细胞白血病(B-ALL)患儿骨髓中干性基因的表达及其与临床预后指标的关系.方法应用Real-time PCR检测32例初诊B-ALL患儿(B-ALL组)和5例骨髓象正常儿童(对照组)的骨髓单个核细胞上干性基因(Oct4、JAG1、Nanog、Sox2、Fgf4等)的表达,比较B-ALL组和对照组的差异,在此基础上结合临床资料(如性别、年龄、外周血白细胞、危险度分层等)进行相关性分析.结果 B-ALL组儿童的相关于性基因Nanog、JAG1、CD133-2、CD44和Runx1的表达水平较对照组明显增高,分别为对照组的2.74±1.00、4.31 ±2.41、10.23±3.21、4.66±1.73和7.44±3.01倍(P＜0.01),Oct4、Sox2、D LL1、Fgf4和COX-2表达水平较对照组明显降低,分别为对照组的15.00％±0.06、13.00％±0.08、18.12％±0.11、4.73％±0.03和9.59％±0.00(P ＜0.01);初诊B-ALL组干性基因表达与其性别、年龄、外周血白细胞计数、骨髓幼稚细胞比例、FAB分型、细胞遗传学异常、融合基因表达等均无相关性,其中JAG1基因表达与B-ALL危险度分层有明显相关性(r=0.755,P＜0.01),其余基因表达与危险度分层无明显相关.结论与正常儿童的骨髓相比较,初诊B-ALL患儿骨髓中干性基因存在异常表达(上调或下调),其中JAG1基因表达与B-ALL的临床危险度分层显著相关,提示JAG1基因可能是B-ALL的危险因子,可能对判断患儿预后及指导临床治疗有潜在价值.
목적 본연구지재탐토초진급성B림파세포백혈병(B-ALL)환인골수중간성기인적표체급기여림상예후지표적관계.방법 응용Real-time PCR검측32례초진B-ALL환인(B-ALL조)화5례골수상정상인동(대조조)적골수단개핵세포상간성기인(Oct4、JAG1、Nanog、Sox2、Fgf4등)적표체,비교B-ALL조화대조조적차이,재차기출상결합림상자료(여성별、년령、외주혈백세포、위험도분층등)진행상관성분석.결과 B-ALL조인동적상관우성기인Nanog、JAG1、CD133-2、CD44화Runx1적표체수평교대조조명현증고,분별위대조조적2.74±1.00、4.31 ±2.41、10.23±3.21、4.66±1.73화7.44±3.01배(P＜0.01),Oct4、Sox2、D LL1、Fgf4화COX-2표체수평교대조조명현강저,분별위대조조적15.00％±0.06、13.00％±0.08、18.12％±0.11、4.73％±0.03화9.59％±0.00(P ＜0.01);초진B-ALL조간성기인표체여기성별、년령、외주혈백세포계수、골수유치세포비례、FAB분형、세포유전학이상、융합기인표체등균무상관성,기중JAG1기인표체여B-ALL위험도분층유명현상관성(r=0.755,P＜0.01),기여기인표체여위험도분층무명현상관.결론 여정상인동적골수상비교,초진B-ALL환인골수중간성기인존재이상표체(상조혹하조),기중JAG1기인표체여B-ALL적림상위험도분층현저상관,제시JAG1기인가능시B-ALL적위험인자,가능대판단환인예후급지도림상치료유잠재개치.
Objective This study investigated the expression of stem genes in bone marrow cells and its relationship with clinical prognostic factors in childhood with B linage acute lymphoblastic leukemia (BALL) at initial diagnosis.Methods Real-time PCR was applied to detect the expression of stem genes(Oct4,JAG1,Nanog,Sox2,Fgf4.etc) in bone marrow of 32 childhood B-ALL patients (B-ALL group) and 5 normal children (control group).The gene expression differences in 2 groups were compared.Their relationship with clinical prognostic factors (e.g.gender,age,white blood cell count,risk stratification,etc.) were assayed.Results:In B-ALL group,the expression of Nanog,JAG1,CD133-2,CD44 and Runx1 was significantly higher than those of control group (P ＜ 0.01).They were 2.74 ± 1.04,4.31 ± 2.41,10.23 ± 3.21,4.66 ± 1.73 and 7.44 ± 3.01 times that of their control groups respectively.While the expression of Oct4,Sox2,DLL1,Fgf4 and COX-2 was statistically lower than those of control group (P ＜ 0.01).They were 15.00％ ± 0.06,13.04％ ±0.08,18.12％ ±0.11,4.73％ ±0.03 and 9.59％ ±0.04 that of their control groups respectively.It was concluded that the expression of those stem genes has no relations among gender,age,white blood cell count,percentage of bone marrow blast cells,FAB subtype,cytogenetic,leukemia fusion gene in childhood BALL.The expression of JAG1 was significantly related to the level of risk stratification (r =0.755,P ＜ 0.01) while others had no statistical correlation with it.Conclusion:Compared to the control group,the stem genes were differentially expressed in B-ALL groups.The expression of JAG1 was correlated to the clinical risk stratification,which suggested the aberrant expression of JAG1 gene may be a risk factor in childhood B-ALL patients.It might have a potential value in predicting the prognosis and guiding clinical treatment.