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目的研究急性淋巴细胞白血病(ALL)患者脑和急性白血病细胞胞浆(BAALC)基因的表达水平及其临床意义。方法 57例经细胞形态学、组织化学染色及流式细胞术免疫学分型确诊的ALL患者,其中男性35例,女性22例;中位年龄23(14～66)岁。FAB分型L1 9例,L2 45例,L3 3例。建立实时荧光定量PCR检测BAALC基因表达的技术,并定量检测57例初发ALL患者BAALC基因的表达水平及进一步分析其与临床疗效的关系。结果 57例初发ALL患者BAALC基因表达水平显著高于对照组。FAB各亚型中BAALC基因表达水平差异无统计学意义(P>0.05),BAALC基因表达水平的高低与初发ALL患者的免疫表型具有显著性相关,T-ALL患者和伴有髓系抗原表达ALL患者BAALC基因表达水平显著高于B-ALL(P<0.05)和不伴有髓系抗原表达ALL患者(P<0.01)。ALL中BAALC基因表达的水平与外周血白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(Plt)及骨髓白血病细胞比例无明显相关性(P>0.05)。BAALC基因高表达ALL患者的完全缓解率(73.3%)同低表达组(81.0%)比较差异无统计学意义(P>0.05),但BAALC基因高表达患者1年复发率(81.8%)明显高于低表达组(44.1%)(P<0.05)。结论 BAALC基因高表达提示可能是ALL患者一个不良预后因素,检测ALL患者BAALC基因表达水平可能有助于指导治疗。
Objective To study the expression of BAALC gene in patients with acute lymphoblastic leukemia (ALL) and its clinical significance. Methods Fifty-seven ALL patients diagnosed by cytomorphology, histochemical staining and flow cytometry immunological typing were enrolled. Among them, 35 were male and 22 were female. The median age was 23 (14-66) years old. FAB type L1 9 cases, L2 45 cases, L3 3 cases. To establish a real-time fluorescence quantitative PCR to detect the expression of BAALC gene, and to quantitatively detect the expression of BAALC gene in 57 cases of newly diagnosed ALL patients and to further analyze its relationship with clinical efficacy. Results The expression of BAALC gene in 57 cases of newly diagnosed ALL patients was significantly higher than that of the control group. There was no significant difference in the expression of BAALC in FAB subtypes (P> 0.05). The level of BAALC gene expression was significantly correlated with the immunophenotype of ALL patients. T-ALL patients and myeloid antigen BAALC gene expression in patients with ALL was significantly higher than that in B-ALL (P <0.05) and non-myeloid antigen (ALL) patients (P <0.01). There was no significant correlation between the level of BAALC gene expression and ALL (WBC), hemoglobin (Hb), platelet count (Plt) and the percentage of myeloid leukemia cells in ALL (P> 0.05). The complete remission rate (73.3%) in ALL patients with BAALC gene expression was not significantly different from that in low expression group (81.0%) (P> 0.05), but the one-year recurrence rate (81.8%) was significantly higher in patients with BAALC gene overexpression In low expression group (44.1%) (P <0.05). Conclusion The high expression of BAALC gene may be a negative prognostic factor in ALL patients. Detecting the expression of BAALC gene in ALL patients may be helpful in guiding the treatment.