婆罗双树样基因4在儿童急性白血病中的表达及临床意义

SALL4 expression in children with acute leukemia and its clinical significance

    摘要
  • 摘要:
      目的  探讨婆罗双树样基因4（sal-like 4，SALL4）在儿童急性白血病中的表达及其临床意义。
      方法  采用实时荧光定量PCR和免疫组织化学技术检测50例初诊急性白血病患儿SALL4 mRNA及蛋白的表达量，以15例免疫性血小板减少性紫癜（immune thrombocytopenic purpura，ITP）为对照；动态观察5例白血病患儿初诊和完全缓解后SALL4 mRNA的表达变化；分析SALL4 mRNA表达量与临床指标的关系。
      结果  SALL4 mRNA在初诊急性B淋巴细胞白血病（B-ALL）、急性髓细胞白血病（AML）中的表达量分别为13.89（1.00~63.15）、11.12（2.31~56.59），显著高于对照组1.00（0.29~1.71）（P < 0.01），在急性T淋巴细胞白血病（T-ALL）中的表达量1.48（0.87~4.81）与对照组无显著差异（P>0.05）；SALL4蛋白表达检测结果与SALL4 mRNA表达结果一致；急性白血病患儿完全缓解后SALL4 mRNA表达量0.98（0.22~1.09）较初诊时28.64（11.20~87.46）显著降低（P < 0.01）。SALL4 mRNA的高表达与外周血高白细胞计数、高危分型、诱导化疗末期微小残留病（minimal residual disease，MRD）呈正相关（r=0.424、r=0.403、r=0.393，P均 < 0.05）；与发病年龄，性别，肝、脾、淋巴结肿大等因素无相关性（P>0.05）。
      结论  SALL4可能促进了儿童B-ALL、AML的发生发展，并有望成为监测治疗效果和判断预后的新指标。

     

    Abstract:
      Objective  To investigate the expression of sal-like 4 (SALL4) gene in children with acute leukemia and analyze its clinical significance.
      Methods  Real-time PCR and immunohistochemistry were used to detect SALL4 mRNA and SALL4 protein expressions in 50 patients initially diagnosed with acute leukemia and in 15 patients with immune thrombocytopenic purpura (ITP), which served as controls. Changes were detected in SALL4 mRNA expression from preliminary diagnosis and after complete remission of 5 acute leukemia patients. The relationship between SALL4 mRNA expression and clinical indicators was analyzed.
      Results  SALL4 mRNA expression is higher in initially diagnosed B-ALL 13.89 (1.00-63.15) and AML 11.12 (2.31-56.59) than in ITP controls 1.00 (0.29-1.71) (P < 0.01). SALL4 mRNA expression in initially diagnosed T-ALL 1.48 (0.87-4.81) and in controls showed no significant difference (P>0.05). SALL4 protein expression is in agreement with SALL4 mRNA expression. SALL4 mRNA expression significantly decreased in complete remission stage 0.98 (0.22-1.09) than in acute phase 28.64 (11.20-87.46) in acute-leukemia patients (P < 0.01). High SALL4 mRNA expression level is positively correlated with high white blood cell count, high risk classification, and high minimal-residual disease at the end of induction chemotherapy (r=0.424, r=0.40, and r=0.393, respectively; P < 0.05), but not with age, gender, hepatomegaly, splenomegaly, and lymphadenectasis (P>0.05).
      Conclusion  SALL4 was found to play an important role in promoting childhood B-ALL and AML, which promises a new target for monitoring the therapeutic effects and evaluating the prognosis of childhood B-ALL and AML.

     

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