Xue Jun, Lin Mao-Fang
Department of Hematology, The First Nanjing People Hospital, Nanjing Medical University, Nanjing 210006, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2006 Apr;14(2):332-6.
The study was aimed to detect expression rate of survivin gene in APL cell and to explore the relationship between its expression and clinical manifestation. PML/RARalpha and survivin mRNA expression were analyzed by using reverse transcriptase polymerase chain reaction (RT-PCR) technique. The results showed: (1) the survivin gene expression was detected in NB4 cell line. By treatment with ATRA, survivin mRNA expression in NB4 cell gradually decreased along with time delay and almost could not be detected at the 72th hour. (2) the positive and negative rate of survivin mRNA expression was 67% and 33% respectively, while in all 36 cases of de novo and relapse APL patients, the PML/RAR(alpha) fusion gene expression was positive. In 22 cases at remission stage, the PML/RARalpha fusion gene expression was negative, and the positive and negative rate of survivin mRNA expression was 36% and 64% respectively. The survivin mRNA expression positive rates in the de novo group, relapse group and PML/RARalpha fusion gene L-type positive group were obviously higher than those in remission period group (P < 0.05) and were significantly lower than those in acute leukemia group (P < 0.05, < 0.001). (3) whether the survivin mRNA expression was positive or negative in 36 cases of de novo and relapse APL patients, all the 36 cases could obtain complete remission. 4 APL patients with positive expression of survivin mRNA had DIC and serious infection (one patient died). The clinical symptom showed slight skin or mucosa bleeding, fever and asthenic in the patients with negative expression of survivin mRNA. When 2 APL patients with positive expression of survivin mRNA had been treated with ATRA, induction differentiation sign in their peripheral blood and bone marrow figures was not obvious. It is concluded that the survivin gene positive expression rate is lower in acute promyelocytic leukemia than that in any other types of leukemia and is related to clinical manifestation.
本研究旨在检测急性早幼粒细胞白血病（APL）细胞中生存素基因的表达率，并探讨其表达与临床表现之间的关系。采用逆转录聚合酶链反应（RT-PCR）技术分析PML/RARα和生存素mRNA的表达。结果显示：（1）在NB4细胞系中检测到生存素基因表达。经全反式维甲酸（ATRA）处理后，NB4细胞中生存素mRNA表达随时间延长逐渐降低，至72小时几乎检测不到。（2）生存素mRNA表达阳性率和阴性率分别为67%和33%，而在36例初发和复发APL患者中，PML/RAR(α)融合基因表达均为阳性。在22例缓解期患者中，PML/RARα融合基因表达为阴性，生存素mRNA表达阳性率和阴性率分别为36%和64%。初发组、复发组及PML/RARα融合基因L型阳性组生存素mRNA表达阳性率明显高于缓解期组（P < 0.05），且明显低于急性白血病组（P < 0.05，< 0.001）。（3）36例初发和复发APL患者中，无论生存素mRNA表达阳性或阴性，36例均获得完全缓解。4例生存素mRNA表达阳性的APL患者发生弥散性血管内凝血（DIC）和严重感染（1例死亡）。生存素mRNA表达阴性的患者临床症状表现为轻微皮肤或黏膜出血、发热及乏力。2例生存素mRNA表达阳性的APL患者经ATRA治疗后，外周血及骨髓象诱导分化征象不明显。结论：急性早幼粒细胞白血病中生存素基因阳性表达率低于其他类型白血病，且与临床表现相关。
