[抗凋亡基因aven在初发急性髓系白血病患者中的表达及其临床意义]

Geng Su-Xia, DU Xin, Weng Jian-Yu, Zhong Li-Ye, Guo Rong, Lu Ze-Sheng, Chen Zhi-Hong

Department of Hematology, Guangdong General Hospital (Guangdong Academy of Medical Sciences), Guangzhou 510080, Guangdong Province, China.

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2009 Dec;17(6):1424-8.

This study was aimed to investigate the aven mRNA expression level of leukocytes from peripheral blood(PB)of de novo patients with acute myeloid leukemia (AML) and analyze its clinical significance, so as to provide a experimental basis for evaluating prognosis. The aven mRNA expression levels in PB samples from 69 de novo AML patients were detected by using real-time quantitative PCR. The relation of aven mRNA level with clinical and hematological characteristics (age, sex, WBC, Hb, Plt, LDH, Blast% in PB and BM, FAB subtype) and treatment outcome (CR rate and relapse rate) were analyzed. 21 normal individuals served as controls. The results showed that the expression level of aven mRNA was between 11.72% and 178.93% (median 37.2%) in de novo AML and between 10.81% and 50.98% (median 28.81%) in normal individuals. Aven mRNA expression level was higher in the AML group than that in the controls (p = 0.006). As aven mRNA expression level was compared with other clinical and hematological parameters, there were significant correlations between aven mRNA expression level and age (r = 0.25, p = 0.039), and between hemoglobin level (r = 0.29, p = 0.019), FAB subtype(r = 0.253, p = 0.036). The median expression level (50.08%) of aven mRNA in older patients (> or = 44 years) was higher then that (32.41%) in younger patients (< 44 years) (p = 0.018). The complete remission (CR) rate after two cycles of chemotherapy in patients with lower aven mRNA level (25/30, 83.33%) was higher than that in patients with higher aven mRNA level(21/30, 70%), but the difference was not significant(p = 0.22). The difference of aven mRNA expression level between AML patients with relapse and AML patents without relapse was not significant (p = 0.076). It is concluded that the expression level of aven mRNA in de novo AML patients obviously increases, the overexpression of aven mRNA likely involves in genesis of AML. The definite relation of aven mRNA expression level with treatment outcome and relapse was not been found.

本研究旨在探讨初诊急性髓系白血病（AML）患者外周血（PB）白细胞中aven mRNA的表达水平并分析其临床意义，为评估预后提供实验依据。采用实时定量PCR检测69例初诊AML患者PB样本中aven mRNA的表达水平。分析aven mRNA水平与临床及血液学特征（年龄、性别、白细胞、血红蛋白、血小板、乳酸脱氢酶、外周血和骨髓原始细胞百分比、FAB亚型）及治疗结局（完全缓解率和复发率）的关系。21名正常个体作为对照。结果显示，初诊AML患者中aven mRNA的表达水平在11.72%至178.93%之间（中位数为37.2%），正常个体中在10.81%至50.98%之间（中位数为28.81%）。AML组中aven mRNA表达水平高于对照组（p = 0.006）。将aven mRNA表达水平与其他临床及血液学参数进行比较，发现aven mRNA表达水平与年龄（r = 0.25，p = 0.039）、血红蛋白水平（r = 0.29，p = 0.019）、FAB亚型（r = 0.253，p = 0.036）之间存在显著相关性。年龄较大（≥44岁）患者中aven mRNA的中位表达水平（50.08%）高于年龄较小（<44岁）患者（32.41%）（p = 0.018）。aven mRNA水平较低的患者化疗两个周期后的完全缓解（CR）率（25/30，83.33%）高于aven mRNA水平较高的患者（21/30，70%），但差异无统计学意义（p = 0.22）。复发AML患者与未复发AML患者之间aven mRNA表达水平的差异无统计学意义（p = 0.076）。结论是，初诊AML患者中aven mRNA的表达水平明显升高，aven mRNA的过表达可能参与了AML的发生。未发现aven mRNA表达水平与治疗结局及复发的确切关系。