儿童急性淋巴细胞白血病nm23-H1基因表达及其与免疫分型的关系

目的：探讨儿童急性淋巴细胞白血病(ALL) nm23-H1基因的表达水平及其与免疫分型的关系。方法：应用半定量逆转录-聚合酶链反应(RT-PCR)的方法检测儿童ALL初治、缓解、难治、复发患儿及正常对照儿童nm23-H1基因的表达水平，观察nm23-H1基因与免疫表型的关系。结果：①初治患儿nm23-H1表达水平明显高于正常对照组（P<0.01）和完全缓解组（P<0.01）；完全缓解组nm23-H1表达水平与对照组差异无显著性（P>0.05），复发组nm23-H1表达水平高于正常对照组（P<0.01）和完全缓解组（P<0.01），与初治差异无显著性(P>0.05)；难治组均为高表达。 ②T-ALL的nm23-H1阳性率高于B-ALL(P<0.05)，且T-ALL的nm23 H1表达水平高于B-ALL（P<0.05）。结论： nm23-H1的表达水平随儿童ALL的病情发展而变化，在初治、复发及难治ALL具有高表达，nm23-H1高表达者预后差，易复发；nm23-H1在T-ALL具有高表达，可能是T-ALL的缓解率低、预后差的原因之一。［中国当代儿科杂志，2009，11-11）：881-884］

Expression of nm23-H1 gene in childhood acute lymphoblastic leukemia and the relationship between nm23-H1 expression and immunophenotype

OBJECTIVE: To study the expression of nm23-H1 gene in children with acute lymphoblastic leukemia (ALL) and the relationship between nm23-H1 expression and immunophenotype. METHODS: nm23-H1 expression was measured by semiquantitative RT-PCR in children with ALL (newly diagnosed, n=40; remission, n=32; relapse, n=16; refractory, n=3). Twenty normal children served as the control group. The relationship between nm23-H1 expression and immunophenotype was evaluated. RESULTS: The expression of nm23-H1 in the newly diagnosed ALL group was significantly higher than that in the control (P<0.01) and the remission groups (P<0.01). There was no difference in the nm23-H1 expression between the remission and the control groups. The expression of nm23-H1 in the relapse group was significantly higher than that in the control (P<0.01) and the remission groups (P<0.01), and similar to that in the newly diagnosed ALL group. The three children with refractory ALL had higher nm23-H1 expression. Both the positive rate and expression of nm23-H1 in children with T-lineage ALL were higher than in children with B-lineage ALL (P<0.05). CONCLUSIONS: The expression level of nm23-H1 varies with the stages of ALL. Newly diagnosed, relapsed and refractory ALL children have higher nm23-H1 expression. High nm23-H1 expression may be associated with a poor prognosis and relapse. A higher expression of nm23-H1 in children with T-ALL may be contributed to a low remission rate and a poor prognosis.［Chin J Contemp Pediatr, 2009, 11 (11):881-884］