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AML1/ETO阳性急性髓系白血病患者galectin-3的表达及临床意义

Galectin-3 Expression and Its Clinical Significance in Acute Myeloid Leukemia with Positive AML1/ETO Fusion Gene

  • 摘要: 目的 探讨AML1/ETO阳性急性髓系白血病(AML1/ETO+ AML)患者半乳凝集素3(galectin-3,gal-3)表达及其临床意义。方法 采用实时定量RT-PCR(RQ-PCR)法检测53例AML1/ETO+ AML患者骨髓单个核细胞中gal-3 mRNA表达水平,ELISA法检测患者外周血gal-3蛋白水平,分析gal-3 mRNA表达与疾病预后的相关性。结果 ①gal-3 mRNA及蛋白在初诊AML1/ETO+ AML患者中呈高表达( P<0.001),初诊患者gal-3 mRNA与蛋白表达呈正相关(r=0.732, P<0.001),疾病完全缓解期外周血gal-3蛋白表达量下降( P<0.001);②初诊时gal-3 mRNA表达水平越高,患者白细胞数量越低( P=0.014),CD34表达和附加染色体异常的比例越高( P=0.001, P=0.026);③gal-3 mRNA高表达组与低表达组在完全缓解(CR)、部分缓解(PR)、诱导期死亡(即早期死亡)率上无明显差异( P>0.05),但两组患者在复发率上差异有统计学意义( P=0.029);④gal-3 mRNA高表达组患者中位总生存率(OS)及无病生存率(DFS)均较低表达组缩短( P=0.007, P=0.015),累积复发率增高( P=0.045),但累积死亡率无明显差异( P>0.05)。Cox风险比例模型提示gal-3 mRNA是影响AML1/ETO+ AML患者OS及DFS的独立指标。结论 骨髓gal-3 mRNA有可能成为AML1/ETO+ AML患者评估预后及指导治疗的重要参考指标。

     

    Abstract: Objective To investigate the mRNA expression of galectin-3 and its clinical significance in acute myeloid leukemia (AML) patients carrying AML1/ETOfusion gene. Methods RQ-PCR method was used to detect the expression of galectin-3 mRNA in bone marrow mononuclear cells of 53 AML patients with AML1/ETO+, ELISA was used to detect the expression of galectin-3 protein in peripheral blood, and the correlations of galectin-3 expression with clinical and laboratory features and outcomes were analyzed. Results The mRNA and protein levels of galectin-3 were significantly higher in newly diagnosed AML1/ETO+ AML patients compared with the control ( P<0.001). Galectin-3 mRNA and protein expressions were positively correlated (r=0.732, P<0.001). Galectin-3 protein was significantly decreased during the period of complete remission (CR)( P<0.001). The mRNA expression of galectin-3 was negatively correlated with the count of white blood cells ( P=0.014), and positively correlated with CD34 expression and additional cytogenetic aberrations (ACA) ( P=0.001, P=0.026). There was no significant difference in CR, partial remission (PR), induction death (early mortality) between galectin-3 high-expression group and low-expression group ( P>0.05), but there was significant difference in recurrence rate between the two groups ( P=0.029). The median overall survival (OS) rate and disease-free survival (DFS) rate were shortened in the high-expression group ( P=0.007, P=0.015) and the cumulative incidence of relapse was increased ( P=0.045), but there was no significant difference in the cumulative incidence of CM(155mmmortality ( P>0.05). Cox regression analysis suggested galectin-3 mRNA level an independent indicator of OS and DFS in AML1/ETO+ AML patients. Conclusion Bone marrow galectin-3 mRNA level may be an important reference index for evaluating the prognosis and guiding the treatment of AML1/ETO+ AML patients.

     

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