髓系白血病中EVI1基因的表达及其临床意义

目的研究EVI1基因在成人急性髓系白血病(AML)和慢性粒细胞白血病(CML)中的表达及其临床意义。方法采用多重逆转录-聚合酶链反应(多重RT-PCR)技术分析2002年9月至2005年3月华中科技大学同济医学院附属同济医院收治的45例AML和43例CML骨髓单个核细胞中EVI1基因mRNA的表达,分析EVI1mRNA阳性白血病患者的临床特征及疗效。结果45例AML患者中有8例(17.8%)EVI1阳性,其中M11例、M23例、M54例。43例CML患者中有8例(18.6%)EVI1阳性,其中慢性期2例,占5.7%(2/35),加速期与急变期各3例,均占75.0%(3/4),加速期与急变期组的EVI1基因表达率高于慢性期组(P<0.01)。EVI1阳性的AML患者早期病死率高;EVI1基因阳性表达与CML白血病临床分期及预后相关。结论EVI1基因的高表达在髓系白血病的发生中,特别是在慢性粒细胞白血病慢性期向急性期转化中起重要作用。

The expression and clinical significance of EVI1 gene in myeloid leukemia

Objective To study the expression of EVI1 gene in adults with acute myeloid leukemia(AML)or chronic myeloid leukemia(CML)and to investigate the significance of the detection of EVI1 fusion gene in the diagnosis and prognosis of patients with AML or CML.Methods From Sep.2002 to Mar.2005,expression of EVI1 fusion gene was detected in 45 acute myeloid leukemia(AML)and 43 chronic myeloid leukemia(CML)patients with multiplex nested RT-PCR.The main clinical data and treatment effect in patients with AML or CML carrying the EVI1 fusion gene were studied.Results EVI1 mRNA was positive in 8 of 45(17.8%)AML,including one M1,three M2 and four M5.EVI1 mRNA was positive in 8 of 43 AML(18.6%),including 2 of 35(5.7%)CML-chronic phase(CP),3 of 4(75.0%)CML-accelerated phase(AP),3 of 4(75.0%)CML-blast crisis(BC).The positive rate of EVI1 expression was higher in CML-BC and CML-AP than in CML-CP(P < 0.01).The survival duration of AML patients who expressed EVI1 was short.The expression of EVI1 gene was related to the phase and prognosis of CML.Conclusion Increased expression of the EVI1 gene may play an important role in development of human myeloid leukemias,especially in progression from chronic phase to blastic crisis of CML.