Zhao You-shan, Yang Rui, Gu Shu-cheng, Guo Juan, Zhang Xi, Wu Ling-yun, Li Xiao, Chang Chun-kang
Department of Hematology, Shanghai Jiaotong University, Shanghai, China.
Zhonghua Xue Ye Xue Za Zhi. 2012 Oct;33(10):847-51.
To study the methylation status of p73 gene promoter in patients with myelodysplastic syndrome (MDS) and explore its significance with clinical prognosis.
Methylation of p73 promoter was detected in bone marrow cells from 135 MDS patients and 13 healthy controls by methylation-specific PCR (MSP). The results of MSP were confirmed by bisulfite sequencing. The expression of p73 mRNA was detected by real-time quantitative PCR. Primary bone marrow cells from MDS patients were treated with decitabine, the changes of p73 methylation status and p73 mRNA expression were measured. The role of p73 methylation in the prognosis of MDS and the correlated clinical data were explored.
p73 hypermethylation was present in 37.04% of MDS cases and patients with high risk MDS (RAEB-1 and RAEB-2) exhibited a significantly higher frequency of p73 methylation than that of low risk MDS (58.8% vs 29.7%, P = 0.002). The expression of p73 mRNA in the methylated group was decreased compared to that of the unmethylated group (P = 0.032). Decitabine treatment decreased the level of p73 methylation and increased the level of p73 transcripts. Patients with p73 methylation progressed rapidly to AML (P < 0.001) and had shorter survival (P = 0.002) than those who did not have p73 methylation. In the multivariate Cox regression model, BM blast and p73 methylation status emerged as independent prognostic factor for overall survival and leukemia free survival.
p73 gene methylation is common in patients with MDS and may indicate poor prognosis. p73 may be a therapeutic target in MDS.
研究骨髓增生异常综合征(MDS)患者p73基因启动子的甲基化状态,并探讨其与临床预后的关系。
采用甲基化特异性PCR(MSP)检测135例MDS患者及13例健康对照者骨髓细胞中p73启动子的甲基化情况。MSP结果经亚硫酸氢盐测序验证。采用实时定量PCR检测p73 mRNA的表达。用阿扎胞苷处理MDS患者的原代骨髓细胞,检测p73甲基化状态和p73 mRNA表达的变化。探讨p73甲基化在MDS预后中的作用及相关临床资料。
37.04%的MDS病例存在p73高甲基化,高危MDS(RAEB-1和RAEB-2)患者p73甲基化频率显著高于低危MDS患者(58.8%对29.7%,P = 0.002)。甲基化组p73 mRNA的表达低于未甲基化组(P = 0.032)。阿扎胞苷治疗降低了p73甲基化水平,增加了p73转录本水平。与未发生p73甲基化的患者相比,发生p73甲基化的患者进展为急性髓系白血病的速度更快(P < 0.001),生存期更短(P = 0.002)。在多因素Cox回归模型中,骨髓原始细胞比例和p73甲基化状态是总生存和无白血病生存的独立预后因素。
p73基因甲基化在MDS患者中常见,可能提示预后不良。p73可能是MDS的一个治疗靶点。