T 细胞型急性淋巴细胞白血病患者HOX11L2 基因的表达及其临床意义

目的　研究T 细胞型急性淋巴细胞白血病（acute lymphoblastic leukemia, ALL）患者HOX11L2 基因的表达及其临床意义。方法　采用回顾性分析方法对50 例患者性别、年龄、白细胞数量、FAB 分类（L1,L2 and L3）、分子生物学特点以及生存时间进行分析,观察HOX11L2 基因表达与临床特点及预后关系。结果　50 例T 细胞型急性淋巴细胞白血病患者中,表达HOX11L2 基因患者为12 例（24%）,其中男性7 例（58.3%）,女性5 例（41.7%）,HOX11L2基因表达者在男女性别之间的比较,差异无统计学意义（χ2=0.119,P=0.730）。表达HOX11L2 基因患者年龄在5~10岁间居多,表达率为58.3%,与其它年龄组之间的比较,差异有统计学意义（χ2=11.577,P=0.018）。HOX11L2 基因表达患者中白细胞计数≤ 50×109/L 的患者10 例（83.3%）,白细胞计数>50×109/L 的患者2 例（16.7%）,两组比较差异有统计学意义（χ2=5.469,P=0.019）。FAB 分类中,有75% 的HOX11L2 基因表达患者为L1 型,与L2 和L3 组相比较,差异有统计学意义（χ2=8.766,P=0.008）。其中34 例获得随访资料的患者,HOX11L2 基因表达组比非表达组生存时间短（中位生存时间分别为8.0 个月和11.0 个月）,两组差异具有统计学意义（P<0.05）。结论　研究结果表明HOX11L2 基因主要表达于T-ALL 患者,且以L1 型儿童T-ALL 为主,HOX11L2 基因表达者预后不良,生存时间短。临床上通过HOX11L2 基因检测结果与常规细胞形态学、遗传学、荧光原位杂交等技术检测结果相结合,将对急性淋巴细胞白血病的鉴别诊断、分型、预后及微小残留病检测等具有十分重要的意义。

Expression and Clinical Significance of HOX11L2 Gene in Patients with TCell Acute Lymphoblastic Leukemia

Objective　To study the expression and clinical significance of HOX11L2 gene in patients with T-cell acutelymphoblastic leukemia（T-ALL）. Methods　The sex,age,eukocyte count,FAB classification (L1,L2 and L3),molecular biological characteristics and survival time of 50 patients were analyzed retrospectively. The relationship betweenHOX11L2 gene expression,clinical characteristics and prognosis was observed. Results　Among the 50 patients with T-ALL,12 (24%) expressed HOX11L2 gene,7 (58.3%) males and 5 (41.7%) females. There was no significant difference between thetwo groups in gender (χ2=0.119, P=0.730). Most of the patients with HOX11L2 gene were aged 5~10 years old,the expressionrate was 58.3%,compared with other patients, the difference between the age groups was statistically significant (χ2=11.577,P=0.018).Among the patients with HOX11L2 gene expression,10 patients (83.3%) had WBC count ≤ 50 × 109 / L,and 2patients (16.7%) had WBC count > 50 × 109 / L,and the difference between the two groups was statistically significant(χ2=5.469,P=0.019). In the FAB classification,75% of the patients with HOX11L2 gene expression were L1 type,and thedifference was statistically significant compared with L2 and L3 groups (χ2=8.766,P=0.008). Among the 34 patients whoobtained follow-up data,the survival practice of HOX11L2 gene expression group was shorter than that of non expression group (median survival time was 8.0 months and 11.0 months respectively),and the difference between the two groups was statisticallysignificant (P < 0.05). Conclusion　The results showed that HOX11L2 gene was mainly expressed in T-ALL patients,and itwas mainly expressed in L1 children. The prognosis of HOX11L2 gene expression patients was poor,and the survival time wasshort. Clinically,the results of HOX11L2 gene detection combined with the results of conventional cytomorphology,genetics,fluorescence in situ hybridization and other technologies will be used for the differential diagnosis,typing,prognosisand microanalysis of acute lymphoblastic leukemia Detection of small residual diseases is of great significance.