Zang Yu-Zhu, Chen Xiang-Li, Bai Yan-Liang, Zhang Wen-Hui, Yu Run-Hong
Department of Hematology, Henan Province People's Hospital, Zhengzhou 450003, Henan Province，China.E-mail:
Department of Hematology, Henan Province People's Hospital, Zhengzhou 450003, Henan Province，China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2019 Feb;27(1):123-128. doi: 10.7534/j.issn.1009-2137.2019.01.020.
To investigate the expression of C/EBPα gene in elderly patients with multiple myeloma （MM） and its prognostic significance.
Sixty-nine olderly patients with multiple myeloma (MM) treated in our hospital from February 2015 to October 2017 were selected and enrolled in the MM group, 38 healthy persons received physical examination were selected and enrolled in the control group. The bone marrow of 2 groups was collected and the mononuclear cells were isolated.The mRNA expression level of C/EBPα gene in mononuclear cells was determined by RT-PCR, the Western blot was used to detect the protin expression level of PBMNC C/EBPα, and the protein level of C/EBPα in bone marrow was detected by immunohistochemistry. The correlations of C/EBPα gene expression with the clinical characteristics and survival time in MM patients were analyzed.
The expression level of mRNA and protein of C/EBPα in MM patients was significantly lower than that in the control group (P<0.05). The expression level of C/EBPα gene significantly correlated with the ISS stage, CRP, Calcium, β2-MG, LDH and the percentage of myeloma cells in MM patients (P<0.05). The expression of C/EBPα gene was not correlate with sex, age, immunoglobulin typing, Hb in MM patients (P>0.05).Immunohistochemical staining showed that the bone marrow samples of the control group were stained more deeply, and the staining intensity in bone marrow samples of MM patients with CR, PR and relapse was successively descended. The protein level of C/EBPα in CR patients with MM was significantly higher than that in PR and relapsed patients by Western blot (P<0.05). Kaplan-Meier survival analysis showed that OS and DFS in the patients with high expression of C/EBPα gene were higher than those in low expression group (P<0.05). Multivariate Cox regression analysis showed that CRP,ratio of myeloma cells and C/EBPα gene were independent factors affecting OS and PFS (P<0.05).
The expression level of C/EBPα gene in MM patients is low that may stimulate the genesis of MM, and the expression of C/EBPα gene closely relates with the development of MM disease.
探讨C/EBPα基因在老年多发性骨髓瘤（MM）患者中的表达及其预后意义。
选取2015年2月至2017年10月在我院治疗的69例老年多发性骨髓瘤患者纳入MM组，选取38例接受体检的健康人纳入对照组。采集两组骨髓并分离单个核细胞。采用RT-PCR法检测单个核细胞中C/EBPα基因的mRNA表达水平，采用Western blot法检测外周血单个核细胞C/EBPα的蛋白表达水平，采用免疫组化法检测骨髓中C/EBPα的蛋白水平。分析MM患者C/EBPα基因表达与临床特征及生存时间的相关性。
MM患者C/EBPα的mRNA和蛋白表达水平均显著低于对照组（P<0.05）。MM患者C/EBPα基因表达水平与国际分期系统（ISS）分期、C反应蛋白（CRP）、血钙、β2-微球蛋白（β2-MG）、乳酸脱氢酶（LDH）及骨髓瘤细胞百分比显著相关（P<0.05）。MM患者C/EBPα基因表达与性别、年龄、免疫球蛋白分型、血红蛋白（Hb）无关（P>0.05）。免疫组化染色显示，对照组骨髓样本染色较深，MM患者完全缓解（CR）、部分缓解（PR）及复发患者骨髓样本染色强度依次降低。Western blot检测显示，MM患者CR组C/EBPα蛋白水平显著高于PR组和复发组（P<0.05）。Kaplan-Meier生存分析显示，C/EBPα基因高表达患者的总生存期（OS）和无病生存期（DFS）高于低表达组（P<0.05）。多因素Cox回归分析显示，CRP、骨髓瘤细胞比例和C/EBPα基因是影响OS和无进展生存期（PFS）的独立因素（P<0.05）。
MM患者C/EBPα基因表达水平较低，可能促进MM的发生，且C/EBPα基因表达与MM疾病进展密切相关。
