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目的:探讨成人急性淋巴细胞白血病(ALL)患者ETS相关基因(ERG)的表达水平及其临床意义。方法:实时荧光定量PCR法检测91例初治成人ALL患者ERG的表达水平,并分析其与临床预后的关系。结果:91例ALL骨髓标本中ERG表达水平显著高于对照组,P<0.001。ALL患者ERG表达水平与就诊时外周血白细胞计数(WBC)、血红蛋白(HGB)、血小板计数(PLT)和血清乳酸脱氢酶(LDH)水平均无明显相关性,P均>0.05。B-ALL患者ERG表达水平与T-ALL组比较差异无统计学意义,P=0.547。BCR/ABL基因阳性ALL患者ERG表达水平与BCR/ABL阴性者比较差异无统计学意义,P=0.889。伴有髓系抗原表达组ALL患者与未伴有髓系抗原表达组之间ERG表达水平也差异无统计学意义,P=0.150。尽管ERG高表达ALL患者的CR率(72.7%)与低表达组(75.4%)比较差异无统计学意义,P=0.804,但ERG高表达ALL患者的复发率(62.5%)显著高于ERG低表达组(34.6%),P=0.047。ERG高表达ALL患者的总生存率显著低于ERG低表达组,P=0.016。结论:ERG高表达可能是ALL一个重要的预后不良因素,检测ALL患者ERG表达水平有助于判定预后,指导治疗。
Objective: To investigate the expression of ETS related gene (ERG) in adult patients with acute lymphoblastic leukemia (ALL) and its clinical significance. Methods: Real-time PCR was used to detect the expression of ERG in 91 newly diagnosed adult ALL patients and its relationship with clinical prognosis was analyzed. Results: ERG expression in 91 cases of ALL bone marrow specimens was significantly higher than that of the control group (P <0.001). There was no significant correlation between the level of ERG expression and peripheral white blood cell count (WBC), hemoglobin (HGB), platelet count (PLT) and serum lactate dehydrogenase (LDH) level in ALL patients. There was no significant difference in ERG expression level between B-ALL patients and T-ALL patients (P = 0.547). There was no significant difference in ERG expression between BCR / ABL gene positive ALL patients and BCR / ABL negative patients (P = 0.889). There was no significant difference in ERG expression between ALL patients with myeloid antigen expression group and those without myeloid antigen expression group, P = 0.150. Although the CR rate (72.7%) in ERG-overexpressing ALL patients was not significantly different from that in low-expression patients (75.4%) (P = 0.804), the recurrence rate was significantly higher in patients with ERG-overexpressing ALL (62.5% Expression group (34.6%), P = 0.047. The overall survival rate of ERG-overexpressing ALL patients was significantly lower than that of ERG-overexpressing patients, P = 0.016. CONCLUSION: High ERG expression may be an important prognostic factor for ALL. Detecting ERG expression in ALL patients is helpful in predicting prognosis and guiding treatment.