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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. -
Key words:
- SALL4 /
- acute leukemia /
- children /
- risk classification /
- MRD
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图 1 琼脂糖凝胶电泳验证SALL4 mRNA在初诊白血病和对照中的表达
Figure 1. Agarose gel electrophoresis verification of SALL4 mRNA expression in initially diagnosed cases of acute leukemia and controls
1, 2:AML; 3-5:B-ALL; 6:T-ALL; 7:Control
图 2 琼脂糖凝胶电泳验证SALL4 mRNA在白血病患儿初诊期和缓解期的表达
Figure 2. Agarose gel electrophoresis verification of SALL4 mRNA expression in patients with acute leukemia after initial diagnosis and remission stages
1, 3, 5:Preliminaly diagnosis period; 2, 4, 6:Remission stage
图 3 免疫组织化学检测SALL4蛋白在各组中的表达 （H & E×400）
Figure 3. SALL4 protein expression in various groups detected by immunohistochemistry(H & E×400)
A:AML; B:Control; C:B-ALL; D:T-ALL; Arrow:Positively stained cells
表 1 46例B-ALL、AML患儿SALL4 mRNA表达量和临床指标的关系
Table 1. Relationship of SALL4 mRNA expression with clinical indicators of 46 children with B-ALL or AML
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