老年与非老年组多发性骨髓瘤的临床细胞遗传学和预后的比较

目的 研究老年多发性骨髓瘤(multiple myeloma,MM)的细胞遗传学、临床因素与预后的相互关系.方法 采用添加细胞因子的改良72 h培养法制备染色体标本,用R显带技术,对64例MM进行核型分析.结果 29例65岁以下MM患者中,发现有异常核型7例,发生率24.14%(7/29);伴多发性骨破坏13例,发生率44.83%(1 3/29).35例65岁以上的老年MM患者中,发现有异常核型16例,发生率45.71%(16/35);伴多发性骨破坏22例,发生率62.85%(22/35).结论 老年组与非老年组MM患者在细胞遗传学、骨破坏程度、骨髓浆细胞百分比的差异均有统计学意义.     

p15基因甲基化在骨髓增生异常综合征中的变化

目的:探索p15基因异常甲基化在骨髓增生异常综合征中的变化及其在各亚型中的表达。方法:采用MSP(Methylation-specific-PCR)的方法,研究p15基因异常甲基化在32例骨髓增生异常综合征(MDS)及其各亚型中的发生率。结果:在MDS中p15基因异常甲基化占50%(16/32);在各亚型中的比例为:难治性贫血(RA)为0%,难治性贫血伴环状铁粒幼细胞(RA-S)为20%(1/5),难治性贫血伴原始细胞增多(RAEB)为57.1%(4/7),慢性粒单核细胞白血病(CMML)为71.4%(5/7),难治性贫血伴原始细胞转化型(RAEB-T)为85.7%(6/7)。其中4例是在亚型间转型或进展为急性髓性白血病(AML)时发生p15基因异常甲基化。结论:p15基因甲基化可能是MDS发病的原因之一,并与MDS病程进展有关;其各亚型并非独立的分型,亚型间因病情的进展而转型时易有p15基因异常甲基化的发生。     

非何杰金淋巴瘤p15基因操纵区5’-CpG岛的甲基化的研究

目的：探索p15基因异常甲基化在非何杰金淋巴瘤(NHL)中的变化及其在各分型中的表达。 方法：用特异PCR（MSP）的方法检测32例非何杰金淋巴瘤石蜡标本p15基因甲基化；检测非何杰金淋巴瘤患者标本21例，用RT-PCR方法测定p15基因的表达。 结果:非何杰金淋巴瘤p15基因操纵区甲基化的发生率为18.9%（10/53），高度恶性比低度恶性更易发生甲基化，其发生率分别为27.3%和0%。 结论:p15基因甲基化可能是非何杰金淋巴瘤发病的原因之一，并与病程进展有关。     

多发性骨髓瘤患者外周血CD3ε基因的表达特点

目的:建立荧光定量PCR法检测CD3ε链表达水平的方法,了解多发性骨髓瘤(MM)T细胞信号传导分子CD3ε基因的表达特点。方法:采用SYBR GreenⅠ荧光定量PCR和相对定量分析法检测22例MM患者及22例正常人外周血单个核细胞CD3ε基因的表达情况,以β2微球蛋白基因(β2M)作为内参,22例健康人作为对照,采用相对定量公式:2-△Ct×100%,计算MM患者CD3ε基因相对mRNA表达量。结果:MM患者和正常人外周血单个核细胞均表达CD3ε基因,具体表达量呈现很大的个体差异性。MM患者CD3ε基因mRNA相对表达量最高为39.78%,最低为0.48%,正常人CD3ε基因mRNA相对表达量最高为5.15%,最低为0.01%。MM患者CD3ε基因表达量明显高于正常人(P0.05)。结论:成功建立SYBR GreenⅠ荧光定量PCR法检测CD3ε链表达水平的方法,率先报道了多发性骨髓瘤中CD3ε基因高表达的特点,为了解多发性骨髓瘤T细胞免疫学特点提供新的资料。     

流式细胞术免疫表型分析在多发性骨髓瘤及其他浆细胞疾病诊断中的应用

多发性骨髓瘤(multiple myeloma,MM)是以骨髓内单克隆恶性浆细胞增生,伴有单克隆免疫球蛋白或轻链增多为特征的恶性肿瘤。骨髓中异常浆细胞数量为其主要诊断标准和疗效判断依据之一,但是,MM有别于其他血液系统恶性肿瘤,骨髓瘤细胞在骨髓中往往呈灶性分布,骨髓穿刺部位不同,细胞数量差异很大。有时肿瘤浆细胞和正常浆细胞形态     

骨髓增生异常综合征与白血病细胞p15INK4B基因甲基化及机制研究

目的:探讨p15INK4B基因甲基化异常和血液系统肿瘤发病的关系及甲基化异常的机制。方法:采用RT-PCR、甲基化特异PCR、Western blot法检测20例骨髓增生异常综合征(MDS)、20例急性白血病患者(AL)、14例慢性粒细胞性白血病(CML)患者骨髓单个核细胞p15INK4B基因 mRNA和p15INK4B蛋白的表达、p15INK4B基因甲基化及甲基转移酶(DNMTs)的表达。结果:高危组MDS患者p15INK4B蛋白表达阳性率低于低危组MDS患者(10% vs 80%,P<0.01),p15INK4B基因甲基化阳性率较高(60% vs 10%,P<0.01)。20例AL有9例(45%)存在p15INK4B基因甲基化。10例CML慢性期(CML-CP)患者仅1例存在p15INK4B基因甲基化。4例CML急变期(CML-BP)患者均检测到p15INK4B基因部分甲基化。DNMT_3A、DNMT_3B表达在AL、高危组MDS和CML-BP患者均明显高于低危组MDS(P<0.05)。结论:p15INK4B基因甲基化在AL、高危组MDS和CML-BP患者发生率高于低危组MDS,伴有甲基转移酶DNMT_3A、DNMT_3B表达较高。p15INK4B基因甲基化可能参与MDS和AL的发病机制并与MDS 及CML的预后有关。     

多重PCR方法检测多发性骨髓瘤患者重排基因的研究

目的　探讨分子生物学方法在多发性骨髓瘤诊断中的意义。方法　采用多重 Ｐ Ｃ Ｒ 联合 Ｓｏｕｔｈｅｒｎ 杂交方法检测２９ 例多发性骨髓瘤患者骨髓及外周血标本 Ｉｇ Ｈ Ｃ Ｄ ＲⅢ及 Ｔ Ｃ Ｒ ＶγⅠ Ｊγ重排基因。结果　８９ ．７ ％ （２６／２９） 和６５ ．５ ％ （１９／２９） 的患者骨髓标本存在 Ｉｇ Ｈ 及 Ｔ Ｃ Ｒ ＶγⅠ Ｊγ重排基因,而在外周血标本,仅５５ ．２ ％ （ １６／２９） 和３７ ．９ ％ （１１／２９） 存在 Ｉｇ Ｈ 及 Ｔ Ｃ Ｒ 重排基因。联合检测 Ｉｇ Ｈ Ｃ Ｄ ＲⅢ和 Ｔ Ｃ Ｒ ＶγⅠ Ｊγ重排基因,９３ ．１ ％ （２７／２９） 骨髓标本及５８ ．６ ％ （１７／２９） 外周血标本存在 Ｉｇ Ｈ 或／ 和 Ｔ Ｃ Ｒ 重排基因,外周血标本Ⅱ期和Ⅲ期患者重排基因阳性率（７１ ．４ ％ ） ,显著高于Ⅰ期患者（２５ ％ ）（ Ｐ＜ ０ ．０５） 。结论　 Ｐ Ｃ Ｒ 技术检测多发性骨髓瘤患者重排基因对诊断是有帮助的, 尤其是骨髓标本。多重 Ｐ Ｃ Ｒ 方法可在一个 Ｐ Ｃ Ｒ 循环中同时扩增两个重排基因,更简便、经济,更适宜临床实际应用。     

多发性骨髓瘤患者TNF-α和β_2-m联检的临床应用价值探讨

目的：探讨多发性骨髓瘤患者血浆肿瘤坏死因子（TNF-α）、β2-微球蛋白（β2-m）联检的临床应用价值。方法：本院38例经血液病诊断标准确诊的多发性骨髓瘤（MM）患者,采用放射免疫分析测定其TNF-α和β2-m水平并进行分析,同时选取30名体检健康者作为对照。结果：①初诊MM患者（14例）及复发患者（16例）的TNF-α和β2-m水平均显著高于平稳期MM患者和对照组,差异有统计学意义（P〈0.01）。②Ⅲ期MM患者血浆TNF-α和β2-m水平均显著高于Ⅱ期患者,Ⅱ期患者又显著高于Ⅰ期患者,差异均有统计学意义（P〈0.01）;Ⅲb期MM患者血浆TNF-α水平显著高于Ⅲa期,差异有统计学意义（P〈0.01）,而β2-m水平无统计学差异（P〉0.05）;Ⅱb期MM患者的β2-m水平显著高于Ⅱa,差异有统计学意义（P〈0.01）,而TNF-α水平无统计学差异（P〉0.05）。结论：TNF-α和β2-m联检是MM临床分期、预后及疗效判断的有效指标,能指导临床开展有效的诊疗工作。     

多发性骨髓瘤54例临床分析

多发性骨髓瘤（MM）是骨髓中浆细胞进行性增生的恶性肿瘤，起病隐匿，临床表现复杂多样，容易漏诊误诊。本组病例回顾性分析了2001年8月-2003年8月住院治疗的54例患者的临床资料，报告如下：     

TNFα和β2-MG联合检测在多发性骨髓瘤中的应用

为探讨联合检测肿瘤坏死因子(TNFα)、β2-微球蛋白(β2-MG)对多发性骨髓瘤的临床应用价值, 本文对43例符合血液病诊断标准的多发性骨髓瘤(MM)患者与30名健康对照者同时测定TNFα和β2-MG水平.结果显示: ①33例初诊及复发MM患者(其中初诊16例, 复发17例)的TNFα和β2-MG水平明显高于平稳期MM患者及健康对照者(P＜0.01),可作为MM复发的指标之一; ②不同临床分期MM患者TNFα和β2-MG水平不同, 其中Ⅲb期MM患者TNFα水平明显高于Ⅲa期(P＜0.01),Ⅲa期、Ⅲb期患者β2-MG水平无差异 (P＞0.05), 而Ⅱb期β2-MG水平明显高于Ⅱa期(P＜0.01).Ⅱa、Ⅱb期MM患者TNFα水平无差异(P＞0.05).TNFα和β2-MG可作为MM临床分期有效指标.TNFα和β2-MG联合检测对MM临床分期可能会更准确.     

Methylation of INK4 and CIP/KIP families of cyclin-dependent kinase inhibitor in chronic lymphocytic leukaemia in Chinese patients

BACKGROUND: INK4 (p15, p16, p18 and p19) and CIP/KIP (p21, p27 and p57) are two families of cyclin-dependent kinase inhibitors (CKI) targeting CDK4/6 and CDK2, respectively. AIM: To study the role of methylation in the inactivation of CKI in chronic lymphocytic leukaemia (CLL). MATERIALS AND METHODS: Methylation-specific polymerase chain reaction was carried out on DNA obtained from the bone marrow of 56 newly diagnosed patients with CLL. RESULTS: Similar demographic features and clinical outcome were observed in our patients when compared with Caucasian patients, including an indolent clinical course (10-year overall survival 51%) and advanced Rai stage (p = 0.006), and a high-risk karyotype such as trisomy 12 and complex aberrations (p = 0.03). In the INK4 family, methylation in p15 and p16 occurred in 20 (35.7%) and 8 (14.3%) patients, respectively. In all, 5 (8.9%) CLL samples harboured concurrent methylation of both p15 and p16. Apart from an association of p16 methylation with higher presenting leucocyte count (64.5 x 10(9)/l in methylated p16 and 16.0 x 10(9)/l in unmethylated p16 patients; p = 0.016), there was no association between p15 and p16 methylation and age, sex and Rai stage. No difference was observed in the overall survival for patients with and without p15 and p16 methylation. By contrast, p18 and Rb were unmethylated in all samples. In the CIP/KIP family, apart from infrequent methylation of p57 in 4 (7.1%) patients, methylation of p21 and p27 was uniformly absent. CONCLUSION: p15 and, less frequently, p16 of the INK4 family of CKI, instead of the CIP or KIP family, were targeted by methylation in CLL. p16 methylation was associated with a higher lymphocyte count at presentation. This is the first comprehensive study of the epigenetic dysregulation of the INK4 and CIP/KIP families of CKI in Chinese patients with CLL.     

Analysis of cyclin-dependent kinase inhibitor genes (CDKN2A,CDKN2B,and CDKN2C) in childhood rhabdomyosarcoma

p16^INK4A, p15^INK4B, and p18 proteins are highly specific inhibitors of cyclin-dependent serine/threonine kinase (CDK) activities required for G1-S transition in the eukaryotic cell division cycle. Mutations, mainly homozygous deletions, of the CDKN2A (p16^INK4A/MTSI) gene have been recently found in tumor cell lines and in many primary tumors. We looked for homozygous deletions of CDKN2A, CDKN2B (p15^INK4B), and CDKN2C (p18) in 12 primary rhabdomyosarcoma (RMS) specimens and in five cell lines established from this cancer type. By means of polymerase chain reaction (PCR) and PCR-single strand conformation polymorphism (PCR-SSCP), we analyzed the presence of biallelic gene deletion or point mutation causing gene function loss. All the examined tumor cell lines (100%) and three of 12 (25%) primary tumors showed homozygous deletion of CDKN2A. Furthermore, no aberrant bands in primary tumors were detected via SSCP, suggesting the absence of mutations in the coding region. In all cases the deleted area at 9p21 also involved the CDKN2B gene. Conversely, no homozygous deletion or point mutations were detected when CDKN2C was analyzed. Our results strongly indicate that the p16^INK4A (and/or p15^INK4B) protein plays a key role in the development and/or progression of childhood rhabdomyosarcoma and suggest that this CDK-inhibitor protein might control proliferation and/or differentiation of human muscle cells. Moreover, alteration of CDKN2C does not appear to be involved in the genesis of rhabdomyosarcoma. Genes Chromosom Cancer 15:217–222 (1996). © 1996 Wiley-Liss, Inc.     

Prognostic significance of O6‐methylguanine DNA methyltransferase and p57 methylation in patients with diffuse large B‐cell lymphomas

To evaluate whether promoter methylation is related to responsiveness for chemotherapy or clinical outcome, we performed an association analysis between methylation and clinical outcomes. Patients with nodal diffuse large B‐cell lymphomas (DLBCL) at a single institute (n=44) were studied for methylation of tumor‐related genes, MGMT, p15^INK4B, p16^INK4A, p16^INK4A, Mad2, TMS1/ASC, CASP8, and GSTP1. The clinical behavior of DLBCL after chemotherapy was followed up and analyzed. Hypermethylation of promoters of MGMT, p15^INK4B, p16^INK4A, p16^INK4A, Mad2, and TMS1/ASC genes was observed in 52.3%, 31.8%, 54.5%, 47.7%, 50%, and 2.3% of the cases, respectively. Methylation of CASP8 and GSTP1 genes was not observed. Promoter methylation was not related to chemo‐responsiveness, disease‐free survival, and progress of disease after chemotherapy. However, in overall survival analyses, MGMT methylation (p<0.05) and responsiveness to chemotherapy (p<0.01) were significant prognostic factors in patients with DLBCL. In the low‐risk group, patients with p57 methylation showed longer overall survival than patients without p57 methylation (p=0.02) and all patients with p57 methylation were alive during follow‐up. Our results demonstrate that aberrant promoter methylation of MGMT and p57 is an additional biological marker for predicting increased overall survival in patients with DLBCL.     

成骨样细胞体外培养法筛选杜仲叶防治骨质疏松症的药效成份

目的 探讨杜仲叶提取成份对体外培养的成骨样细胞代谢功能的影响,筛选杜仲叶防治骨质疏松的药效成份。方法 从杜仲叶提取分离出4个化合物,以不同浓度(10-4g/L、10-6g/L、10-8g/L)加入体外培养的MG-63成骨细胞株中,并设空白组和对照组。培养4 d后,MTT比色法测定细胞增殖,对硝基磷酸盐法测定培养基中ALP活性。结果 细胞增殖数量与对照组比较,成份I 10-6g/L浓度组、Ⅱ、Ⅲ10-8g/L浓度组和成份Ⅳ10-4g/L、Ⅲ10-8g/L浓度组显著提高(P<0.05);成份Ⅱ、Ⅲ的10-4g/L、10-6g/L浓度组和成份Ⅳ10-6g/L浓度组极显著提高(P<0.01)。ALP活性与对照组比较,成份I 10-6g/L浓度组、成份Ⅱ10-4g/L、10-8g/L浓度组、成份Ⅲ10-8g/L浓度组和成份Ⅳ的10-4g/L、10-8g/L浓度组有显著性增强;成份Ⅱ10-6g/L浓度组和成份Ⅲ的10-4g/L、10-6g/L浓度组均极显著增强(P<0.01)。结论 4个成份均有一定的促进成骨细胞增殖、调节成骨细胞代谢的作用,以Ⅱ和Ⅲ效果明显。     

Hypermethylation of the CDKN2/p16INK4A promotor in thyroid carcinogenesis

Functional inactivation of the p16INK4A gene has been reported to be involved in the development of a variety of human malignancies. In thyroid carcinomas, mutations of the p16INK4A gene or homozygous deletions of the gene locus 9p21 are rare. This study investigated whether p16INK4A promotor methylation is an alternative mechanism for p16INK4A gene inactivation during thyroid carcinogenesis. A methylation-specific polymerase chain reaction protocol was applied. A total of 77 thyroid tumor specimens, including 18 follicular adenomas, 18 follicular carcinomas, 16 papillary carcinomas, 12 poorly differentiated carcinomas, and 13 undifferentiated carcinomas were analyzed longitudinally. In addition, 15 tumor-free thyroid tissues were investigated. The p16INK4A promotor status was compared with p16INK4A protein expression and patient-specific data. p16INK4A promotor hypermethylation was detected in 13% of non-tumorous tissue; in 33% of follicular adenomas; in 44% of papillary carcinomas; in 50% of follicular carcinomas; in 75% of poorly differentiated carcinomas; and in 85% of undifferentiated carcinomas. With the exception of two cases, the p16INK4A protein was lost as a result of promotor hypermethylation. Comparing the methylation status with tumor stage, no correlation was found. However, lymph node and distant metastasis status showed a statistically significant prevalence for the p16INK4A promotor methylation (p = 0.035). There was no association between p16INK4A promotor methylation and age and sex. These results suggest that hypermethylation of the p16INK4A promotor region is a frequent and an early event during thyroid carcinogenesis and is associated with tumor progression and dedifferentiation.     

乳腺癌中p16INK4a和视网膜母细胞瘤基因甲基化状况及其表达

目的 研究乳腺癌及癌旁增生组织中p16INK4a和视网膜母细胞瘤(RB)基因启动子区域的甲基化状况,并探讨基因异常甲基化与蛋白表达及其临床意义.方法 采用甲基化特异性PCR方法 对46例乳腺癌、22例癌旁增生组织及7例正常乳腺组织中p16INK4a和RB基因启动子区域甲基化状况进行检测,并采用免疫组织化学SP法对p16INK4a蛋白表达情况进行相应检测.结果 乳腺癌、癌旁增生组织和正常乳腺组织中p16INK4a基因的甲基化率分别为23.9%(11/46)、18.2%(4/22)、1/7;RB基因的甲基化率分别为10.8%(5/46)、9.1%(2/22)、0(0/7);肿瘤组织、癌旁增生组织和正常乳腺组织中p16INK4a基因、RB基因甲基化率差异均无统计学意义(P>0.05).正常乳腺组织、癌旁增生组织、乳腺癌中p16INK4a蛋白表达阳性率分别为7/7、60.8%(28/46)和81.8%(18/22),三者之间差异无统计学意义(P>0.05);肿瘤组织中p16INK4a蛋白表达与肿瘤分级相关(P<0.05);肿瘤组织中p16INK4a甲基化状况与其蛋白表达、肿瘤分级、ER表达阴性具有相关性(P<0.05),与肿瘤大小、淋巴结转移、年龄均不相关;RB基因甲基化状态与肿瘤分级、肿瘤大小、ER表达及年龄均无相关性,但与淋巴结转移相关(P<0.05).结论 p16INK4a基因异常甲基化可能在乳腺癌发生过程中作用有限,但在肿瘤的演进中发挥作用;RB基因甲基化检测对于分析乳腺癌进展及预后情况可能有一定参考价值;p16INK4a基因甲基化是p16INK4a蛋白失表达的机制之一.     

Aberrant methylation of p14(ARF), p15(INK4b) and p16(INK4a) genes and location of the primary site in pulmonary squamous cell carcinoma

Aberrant methylation of cytosines in CpG islands of the promoter regions of tumor suppressor genes is found in human tumors as a common mechanism of gene silencing. We investigated the methylation status of the chromosome 9p21 gene cluster (p14(ARF), p15(INK4b) and p16(INK4a) genes) by methylation-specific polymerase chain reaction in 20 central and 40 peripheral types of pulmonary squamous cell carcinoma (SqCC) in order to determine the differences between the pathogeneses of the central and peripheral types of SqCC. The frequencies of methylation were 30% for the p14(ARF) gene, 20% for the p15(INK4b) gene and 40% for the p16(INK4a) gene in the central type and 25% for the p14(ARF) gene, 10% for the p15(INK4b) gene and 38% for the p16(INK4a) gene in the peripheral type. Cases in which there was methylation of the p16(INK4a) gene had a higher smoking index in the peripheral type (P = 0.007). This trend was not detected in the central type. Methylation of two or three genes was observed in 55% of methylation in at least one gene of the central type but in only 17% of the peripheral type. This overlap methylation of the chromosome 9p21 gene cluster was found more frequently in the central type (P = 0.02). These findings suggest one of the epigenetic differences between the central and peripheral types of SqCC.     

Promoter methylation profiles of tumor suppressor genes in intrahepatic and extrahepatic cholangiocarcinoma.

Recent studies indicate that tumor suppressor genes can be epigenetically silenced through promoter hypermethylation. To further understand epigenetic alterations in cholangiocarcinoma, we have studied the methylation profiles of 12 candidate tumor suppressor genes (APC, E-cadherin/CDH1, MGMT, RASSF1A, GSTP, RAR-beta, p14ARF, p15INK4b, p16INK4a, p73, hMLH1 and DAPK) in 72 cases of cholangiocarcinoma, including equal number cases of intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma. A total of 10 cases of benign biliary epithelia were included as controls. The methylation status of tumor suppressor genes was analyzed using methylation-specific PCR. We found that 85% of all cholangiocarcinomas had methylation of at least one tumor suppressor gene. The frequency of tumor suppressor gene methylation in cholangiocarcinoma was: RASSF1A (65%), p15INK4b (50%), p16INK4a (50%), APC (46%), E-cadherin/CDH1 (43%), p14(ARF) (38%), p73 (36%), MGMT (33%), hMHL1 (25%), GSTP (14%), RAR-beta (14%) and DAPK (3%). Although single tumor suppressor gene methylation can be seen in benign biliary epithelium, methylation of multiple tumor suppressor genes is only seen in cholangiocarcinoma. About 70% (50/72) of the cholangiocarcinomas had three or more tumor suppressor genes methylated and 52% (38/72) of cases had four or more tumor suppressor genes methylated. Concerted methylation of multiple tumor suppressor genes was closely associated with methylation of RASSF1A, p16 and/or hMHL1. Methylation of RASSF1A was more common in extrahepatic cholangiocarcinoma than intrahepatic cholangiocarcinoma (83 vs 47%, P=0.003) while GSTP was more frequently seen in intrahepatic compared to extrahepatic cholangiocarcinoma (31 vs 6%, P=0.012). Our study indicates that methylation of promoter CpG islands of tumor suppressor genes is a common epigenetic event in cholangiocarcinoma. Based on distinct methylation profiles, intrahepatic cholangiocarcinoma and extrahepatic cholangiocarcinoma are two closely related but biologically unique neoplastic processes. Taking advantage of the unique concurrent methylation profile of multiple genes in cholangiocarcinoma may facilitate the distinction of cholangiocarcinoma from benign biliary epithelium in clinical settings.