摘要
目的探讨p15和SOCS1基因甲基化在骨髓增生异常综合征(myelodysplastic syndromes,MDS)患者中的表达及其临床意义。方法选择2015年4月—2016年11月新疆医科大学第一附属医院67例初诊MDS患者,其中男性39例,女性28例,年龄21~83岁,平均59岁。相对低危组34例(低危6例,中危-Ⅰ28例),相对高危组33例(中危-Ⅱ16例,高危17例)。应用甲基化特异性PCR(methylmion specific PCR,MSP)对67例MDS患者骨髓进行p15和SOCS1基因的甲基化检测,18例缺铁性贫血患者作为对照,分析MDS患者上述2种基因甲基化状况及其与临床特征和生存的关系。结果 67例MDS患者中p15和SOCS1基因甲基化率分别为37.3%和47.8%,18例对照组的甲基化率分别为0.0%(0/18)和5.6%(1/18),差异均有统计学意义(均P<0.05);p15和SOCS1基因甲基化分别与不同临床指标相关,但随着国际预后积分系统(IPSS)分级的升高,2个基因甲基化率均呈增高趋势(P<0.05)。生存分析显示p15基因甲基化与非甲基化患者的中位生存时间分别为8(95%CI:5.2~10.8)个月和26(95%CI:15.8~36.2)个月(均P<0.05),SOCS1基因甲基化与非甲基化患者的中位生存时间分别为7(95%CI:5.0~9.1)个月和26(95%CI:18.2~33.8)个月(均P<0.05)。两基因甲基化共表达在所有患者以及相对低危组和相对高危组患者中生存时间均较非共表达患者的生存时间明显缩短(P<0.05)。多因素分析显示p15和SOCS1基因甲基化是MDS患者预后不良的影响因素。结论 p15和SOCS1基因甲基化是MDS患者不良预后的独立危险因素。
Objective To investigate the expression and clinical significance of p15 and SOCS1 methylation in myelodys- plastic syndrome. Methods We examined 67 MDS patients （39 male and 28 female） with the median age of 59 years （21 -83）. Of them, 34 cases were the relatively low risk groups （low-risk 6 cases, intermediate- I 28 cases）, 33 cases were the relatively high risk groups （intermediate-II 16 cases, high risk 17 cases）. Methylation-specific PCR （MSP） was used to detect the methylation of the above two genes in 67 patients with MDS and 18 patients with iron deficiency a- nemia as controls, to analyze the relationship between p15 and SOCS1 methylation and the clinical indexes. Results The methylation rates of p15 and SOCSI were 37.3% and 47.8% in 67 MDS patients, while 0% and 5.6% in the con- trol group （P 〈 0.05）. The methylation of p15 and SOCS1 were correlated with different clinical indexes, but both in- creased along with the increase of International Prognostic Scoring System （IPSS） scores （ P 〈 0.05 ）. The median overall survival of patients with p15 methylation were 8 （95 % CI： 5.2 - 10.8） months, which was significant different with that of the patients without methylation 26 （95 % CI： 15.8 - 36.2） months （ P 〈 0.05）. The median overall survival of pa- tients with SOCS1 methylation were 7 （95 % CI： 5.0 -9.1 ） months, which was significant different with that of the pa- tients without methylation 26 （ 95 % CI： 18.2 - 33.8 ） months （ P 〈 0.05 ）. Patients with 2 genes methylation had shorter survival time in all patients, the relatively low risk groups and the relatively high risk groups （ P 〈 0.05 ）. In multivariate analysis, p15 and SOCS1 remained negative prognostic factors. Conclusion The methylation of p15 and SOCS1 were in- dependent prognostic factors for overall survival in MDS.
作者
邓春阳
陈双
江明
陈蓉
尼罗帕尔.吐尔逊
王欢
郝建萍
DENG Chun-Yang;CHEN Shuang;JIANG Ming(Center of Hematologic Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumuqi, Xinjiang 830054, Chin)
出处
《中华全科医学》
2018年第5期712-715,共4页
Chinese Journal of General Practice
基金
新疆维吾尔自治区自然科学基金(2015211C046)
