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目的探讨儿童急性淋巴细胞白血病(ALL)不同阶段、不同类型患者nm23-H1基因的表达水平及其对化疗疗效的影响。方法研究对象为2006.12～2008.05哈尔滨市儿童医院血液科、哈尔滨医科大学附属第一医院儿科住院的ALL患儿。应用半定量逆转录-聚合酶链反应(RT-PCR)的方法,检测儿童急性淋巴白血病初治患者、缓解患者、难治患者、复发患者及正常对照儿童nm23-H1基因的表达;观察nm23-H1基因与疗效的关系。结果(1)初治患者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);完全缓解后nm23-H1表达水平与对照组无明显差异(P>0.05),复发/难治组患者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),与初治患者无明显差异(P>0.05);(2)40例初治患者nm23-H1阳性26例,nm23-H1阴性14例,nm23-H1阳性患者的完全缓解(CR)率与nm23-H1阴性患者无明显差异(分别为73.1%、92.9%,P>0.05),但完全缓解患者治疗前nm23-H1表达水平低于未缓解患者(P<0.01)。结论nm23-H1的表达水平随儿童ALL的病情发展而变化,nm23-H1可以作为判断疗效、预测复发、评估预后的一个因素;nm23-H1高表达可能是儿童ALL的不利因素,nm23-H1高表达者疗效差,易耐药,易复发,预后差。
Objective To investigate the expression of nm23-H1 gene in different types of childhood acute lymphoblastic leukemia (ALL) and its effect on the curative effect of chemotherapy. Methods The subjects were ALL children admitted to Department of Hematology, Harbin Children’s Hospital from 2006.12 to 2008.05, and the First Affiliated Hospital of Harbin Medical University. The expression of nm23-H1 gene in children with acute lymphoblastic leukemia, remission, refractory, relapsed and normal control children was detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) H1 gene and efficacy of the relationship. Results (1) The expression of nm23-H1 in newly diagnosed patients was significantly higher than that in normal controls (P <0.01) and complete remission (P <0.01). The expression of nm23-H1 in complete remission was not significantly different from that in control group (P> 0.05). The expression of nm23-H1 in relapsed / refractory group was significantly higher than that in normal control group (P <0.01) and complete remission group (P <0.01) There were 26 cases of nm23-H1 positive and 14 cases of nm23-H1 negative in 40 cases of newly diagnosed patients. The complete remission (CR) rates of patients with nm23-H1 positive were not significantly different from those of patients with nm23-H1 negative (73.1%, 92.9% > 0.05). However, the expression of nm23-H1 in patients with complete remission was lower than that in patients without remission (P <0.01). Conclusion The expression of nm23-H1 may play an important role in the prognosis of children with ALL. Nm23-H1 may serve as a prognostic factor in predicting curative effect and predicting recurrence. High expression of nm23-H1 may be an adverse factor in childhood ALL. The expression of poor efficacy, easy drug resistance, easy to relapse, poor prognosis.