摘要
目的探讨急性髓细胞白血病(AML)患者骨髓单个核细胞(BMMNC)野生型NPM1基因的表达及临床意义。方法采用半定量逆转录聚合酶链反应(RT-PCR)方法检测59例AML患者,分析NPM1基因表达水平与患者性别、年龄、外周血细胞数、骨髓原始幼稚细胞数及临床疗效的关系,并对部分患者NPM1表达水平进行动态观察。结果初治AML患者中NPM1阳性表达率为73.8%,难治复发组NPM1阳性率为100%,完全缓解组NPM1阳性表达率为66.7%,对照组NPM1阳性表达率为60%,但各组之间阳性率差异无统计学意义(P>0.05)。分析表达水平显示,难治复发组NPM1中位表达水平(0.798 8)高于初治组(0.541 0)、完全缓解组(0.483 6)及对照组(0.371 8)(P<0.05)。NPM1高表达组患者有效为63.1%,低于低表达组(88.9%)和不表达组患者(100%)(P<0.05)。NPM1表达强度与外周血白细胞数和骨髓原始细胞数呈正相关(P<0.05)。对12例初治时NPM1基因高表达患者进了动态观察,1个疗程化疗后获完全缓解5例,其表达水平达正常中位水平以下,其余7例为未缓解患者,NPM1表达水平未见明显变化。结论 NPM1基因在AML中均存在不同程度的过度表达现象,NPM1高表达者提示预后差,完全缓解率低,可作为AML预后不良的指标,PCR动态检测AML患者治疗前后NPM1表达水平,可作为判断AML预后和监测微小残留病(MRD)的一项指标。
Objective To investigate and discuss the expression and clinical significance of NPM1 in patients with acute myeloid leukemia（AML）.Methods The 1evels of NPM1 were measured by semiquantitative reverse transcription polymerase chain reaction（RT-PCR）method in 59 AML patients.Then analyze the relationship of the levels of NPM1 and therapeutic effect,patients’ sex,age,peripheral blood cells,blast cells of bone marrow.Results Of newly diagnosed AML patients,NPM1 positive rate was 73.8%,NPM1 positive rate in refractory and recurrent group was 100%,NPM1 positive rate in complete remission group was 66.7%,NPM1 positive rate in control group was 60%,but there was no significant difference between different groups（P〉0.05）.Analysis of expression levels showed that NPM1 median expression level in the refractory and relapsed group（0.7988） was higher than that in newly diagnosed group（0.541 0）,complete remission group（0.483 6） and control group（0.3718）（P〈0.05）.Complete remission rate in patients with high NPM1 expression group was（63.1%,12/19） which was lower than the that in low expression group（88.9%,8/9） and patients with no expression group（100%,10/10）（P〈0.05）.The expression level of NPM1 mRNA markedly correlated with the number of white blood cell and bone marrow blast cell.（P〈0.05）.After a course of chemotherapy,12 newly diagnosed patients with high expression of NPM1 gene were dynamicly observed.5 cases obtained complete remission,and the expression level reached below the normal median level.The remaining 7 patients had no remission,and there was no significant change in expression levels.Conclusion There were different levels of NPM1 over-expression in acute myeloid leukemia.The high expression of NPM1 shows low complete remission rate and poor prognosis,and it can be used as indicators of poor prognosis in AML.Using PCR to dynamically detect the expression of NPM1 in AML patients before and after therapy,we can make it one of the indicators to determine the
出处
《重庆医学》
CAS
CSCD
北大核心
2012年第20期2015-2017,2020,共4页
Chongqing medicine
