中期因子在急性白血病中的表达及其意义

目的 检测中期因子(Midkine,MK)基因在白血病患者中的表达,初步探讨其与白血病的关系.方法 应用实时定量逆转录PCR(RQ-RT-PCR)方法,对181例急性白血病(AL)患者、31名正常人骨髓标本进行了中期因子转录本的检测.结果 中期因子在初治和复发AL患者、AL完全缓解(CR)患者及正常人骨髓细胞均有表达.初治和复发AL患者中期因子表达明显高于正常人及CR患者(P＜0.01及P＜0.05).而正常人与CR患者相比差异无统计学意义.中期因子的表达在B细胞急性淋巴细胞白血病(B-ALL)各亚型(包括pro-B-ALL,common-B-ALL,pre-B-ALL)及各年龄段均有显著升高(P＜0.01),且与T细胞急性淋巴细胞白血病(T-ALL)、急性杂合性白血病及急性髓系白血病(AML)各FAB亚型问差异均有统计学意义(P值均＜0.01);与正常人相比,M2型患者中期因子表达明显升高(P＜0.01),与AML其他FAB亚型相比差异亦有统计学意义(P值均＜0.05);M3患者中期因子表达也较正常人明显升高(P＜0.05),但与除B-ALL和AML-M2外的其他白血病亚型间差异无统计学意义.CD34+患者较CD34-患者中期因子表达显著升高(P＜0.01),AML1-ETO融合基因阳性的M2患者较阴性的M2患者中期冈子表达显著升高(P＜0.05).结论 B-ALL、AML-M2和AML-M3型白血病患者中均存在中期因子基因不同程度的表达升高,为白血病诊断及其发病机制的研究提供了新的方向.

The expression of midkine in acute leukemia and its significance

Objective To analyze the expression of midkine(MK)gene in acute leukemia patients,and explore the relationship between the gene and leukemia.Methods The MK gene expression levels were detected by real-time quantitative RT-PCR(RQ-RT-PCR)in bone marrow(BM)of 181 acute leukemia(AL)patients and 31 normal controls.Results MK gene was expressed in all AL patients,normal controls and AL patients in complete remission(CR).Compared with that in control group and CR group,MK gene expression was significantly increased in AL patients(P＜0.01 and P＜0.05,respectively).No statistical difference was found between CR group and control group.The expression of MK showed a notable increase in aU B-ALL subtypes(including pro-B-ALL,common-B-ALL and pre-B-ALL)as well as in adult and childhood B-ALL patients(P＜0.01).Moreover,the gene expression in B-ALL was also significantly higher than that in T-ALL,HAL and FAB subtypes of AML (P＜0.01).In addition,M2 patients showed significantly increased in MK expression compared with that in normal controls(P＜0.01)and in other FAB subtypes of AML(P＜0.05).Median MK expression level in M3 patients was also significantly higher than that in normal control (P＜0.05),but there was no statistical difference between M3 and other AL subtypes excepting for M2 and B-ALL.MK expression in CD34 positive patients was significantly higher than that in CD34 negative ones (P＜0.01).and within M2 patients,MK expression was higher in patients with t(8;21)than in those without the translocation(P＜0.05).Conclusion MK gene expression is increased with different levels in B-ALL,M2 and M3 patients,which provides novel insights into the leukemogenesis of acute leukemia.