CAJ | 학술논문

目的：研究尾型同源盒基因2（CDX2）在急性髓细胞白血病（AML）患者中的表达及临床意义。方法通过 RT‐PCR方法检测114例初发AML患者及56例诱导化疗后患者骨髓和（或）外周静脉血单个核细胞CDX2基因表达，19例随访患者每3个月定期检测CDX2基因表达。8名健康者外周静脉血和5名缺铁性贫血患者骨髓作为对照。结果114例A M L患者和13名对照的骨髓和（或）外周血单个核细胞均检测到CDX2基因表达。以第一个四分位数为界划分低表达组和高表达组，对照组CDX2基因表达水平均在低表达组，114例A M L患者高表达组90例（78．9％），对照组与A M L患者CDX2基因表达差异有统计学意义（ P＜0．01）。初发患者骨髓和外周静脉血CDX2基因表达呈正相关（ r＝0．656，P＜0．01）。CDX2高低表达组诱导化疗完全缓解（CR）率差异无统计学意义（P＞0．05）。本组 AML 病例 CDX2高表达78．9％。CR患者 CDX2表达量为化疗前的10．3％～86．2％，且随着疗程增加逐步降低，复发时显著升高。随访6个月以上病例19例，两组早期复发率差异无统计学意义（P＞0．05）。结论 CDX2表达量变化反映患者体内白血病细胞负荷，持续高表达可能是预后不良指标之一，可作为染色体核型正常AML微小残留病监测指标。
목적：연구미형동원합기인2（CDX2）재급성수세포백혈병（AML）환자중적표체급림상의의。방법통과 RT‐PCR방법검측114례초발AML환자급56례유도화료후환자골수화（혹）외주정맥혈단개핵세포CDX2기인표체，19례수방환자매3개월정기검측CDX2기인표체。8명건강자외주정맥혈화5명결철성빈혈환자골수작위대조。결과114례A M L환자화13명대조적골수화（혹）외주혈단개핵세포균검측도CDX2기인표체。이제일개사분위수위계화분저표체조화고표체조，대조조CDX2기인표체수평균재저표체조，114례A M L환자고표체조90례（78．9％），대조조여A M L환자CDX2기인표체차이유통계학의의（ P＜0．01）。초발환자골수화외주정맥혈CDX2기인표체정정상관（ r＝0．656，P＜0．01）。CDX2고저표체조유도화료완전완해（CR）솔차이무통계학의의（P＞0．05）。본조 AML 병례 CDX2고표체78．9％。CR환자 CDX2표체량위화료전적10．3％～86．2％，차수착료정증가축보강저，복발시현저승고。수방6개월이상병례19례，량조조기복발솔차이무통계학의의（P＞0．05）。결론 CDX2표체량변화반영환자체내백혈병세포부하，지속고표체가능시예후불량지표지일，가작위염색체핵형정상AML미소잔류병감측지표。
Objective To explore the expression and clinical significance of caudal homeobox gene CDX2 in acute myeloid leukemia(AML) patients .Methods Bone marrow (BM )and peripheral blood (PB)samples were colleted in 114 cases of donor AML patients and 56 patients undergoing chemotherapy .The CDX2 gene expression in every patient′s mononuclera cells were de‐tected by RT‐PCR .Among these patients ,19 cases were detected the gene continuous every three months .Eight healthy PB and five patients with iron deficiency anemia BM as control .Results CDX2 gene transcript levels were detectable in bone marrow mononu‐clear cells from 114 AML patients and 13 healthy donors ,but the level of gene expression was higher in AML patients(90/114 , 78 .9% ) .There was a statistically significant difference between the AML patients and normal donor (P< 0 .01) .The higher or lower expression of CDX2 gene showed no correlation with CR rate .CDX2 gene expression level had a positive correlation in BM and PB mononuclera cells(the correlation coefficient r= 0 .656 ,P< 0 .01) .The expression of CDX2 in patients with CR was 10 .3% -86 .2% of pre‐chemotherapy ,wihch decreased with the treatment course ,while elevated in recurrence .19 cases of patients underwent half a year of follow‐up ,there was no significant difference of the rate of early recurrence in two groups(P>0 .05) .Con‐clusion Higher expression level of CDX2 gene is mostly in AML patients ,but its expression has no relation with CR rate .CDX2 gene may be a prognostic molecular marker in AML patients ,and can be used to monitor the minimal residual disease of Normal chromosome karyotype AML .