CAJ | 학술논문

目的研究同源框转录因子2(Caudal-type homeobox transcription factor 2,CDX2)基因在急性髓系白血病(AML)患者中的表达及其临床意义.方法采用实时定量PCR (RQ-PCR)方法检测108例初发AML患者骨髓单个核细胞CDX2基因的表达,并以7名健康人骨髓作为对照分析其临床意义.结果 108例AML患者的骨髓单个核细胞均检测到CDX2基因表达,中位表达水平为1179.44(14.15～867 961.10).以第1个四分位数为界分为低表达组和高表达组,低表达组27例,高表达组81例.7名健康对照者骨髓单个核细胞也均检测到CDX2表达,但表达水平较低,中位表达水平为105.30(22.30 ～453.11),健康对照与AML患者之间CDX2基因表达差异有统计学意义(P＜0.01);14例FLT3-ITD+患者均在CDX2高表达组(P=0.018),其中10例为正常核型.在接受治疗的83例AML患者和57例WBC≥10×109/L的AML患者组中,CDX2高表达患者完全缓解(CR)率均低于CDX2基因低表达患者(54.7％对63.2％,P=0.046;51.1％对75.0％,P=0.048).结论 CDX2基因异常表达与FLT3-ITD基因突变关系密切,并且CDX2基因高表达患者CR率较低,可能为正常核型AML患者预后不良指标.
목적 연구동원광전록인자2(Caudal-type homeobox transcription factor 2,CDX2)기인재급성수계백혈병(AML)환자중적표체급기림상의의.방법 채용실시정량PCR (RQ-PCR)방법검측108례초발AML환자골수단개핵세포CDX2기인적표체,병이7명건강인골수작위대조분석기림상의의.결과 108례AML환자적골수단개핵세포균검측도CDX2기인표체,중위표체수평위1179.44(14.15～867 961.10).이제1개사분위수위계분위저표체조화고표체조,저표체조27례,고표체조81례.7명건강대조자골수단개핵세포야균검측도CDX2표체,단표체수평교저,중위표체수평위105.30(22.30 ～453.11),건강대조여AML환자지간CDX2기인표체차이유통계학의의(P＜0.01);14례FLT3-ITD+환자균재CDX2고표체조(P=0.018),기중10례위정상핵형.재접수치료적83례AML환자화57례WBC≥10×109/L적AML환자조중,CDX2고표체환자완전완해(CR)솔균저우CDX2기인저표체환자(54.7％대63.2％,P=0.046;51.1％대75.0％,P=0.048).결론 CDX2기인이상표체여FLT3-ITD기인돌변관계밀절,병차CDX2기인고표체환자CR솔교저,가능위정상핵형AML환자예후불량지표.
Objective To explore the expression and clinical significance of Caudal-type homeobox transcription factor 2(CDX2) gene in acute myeloid leukemia (AML) patients.Method Real time quantitative PCR(RQ-PCR)was used to test the expression level of CDX2 gene in 108 de novo AML patients and the clinical features of these patients were analyzed.Results CDX2 gene transcript levels were detectable in bone marrow mononuclear cells from 108 AML patients and 7 healthy donors,the median expression level were 1179.44 (range 14.15-867 961.10) and 105.30 (range 22.30-453.11).There was a statistically significant difference in expression level of CDX2 gene between the AML patients and normal donor (P ＜0.01).All 14 patients with FLT3-ITD+ were in CDX2 gene higher expression group (P =0.018),including 10 patients with normal karyotype.In the 83 treated AML patients (P =0.046) and 57 higher WBC count (≥ 10 × 109/L,P =0.048) patients,the higher expression level of CDX2 gene was associated with lower complete remission (CR) rates.Conclusions Higher expression level of CDX2 gene was seen mostly in AML patients with FLT3-ITD mutation and with lower CR rates.CDX2 gene might be a prognostic molecular marker in AML patients with normal karyotype.