本文選題：急性髓細胞白血病 + EVI基因　； 參考：《臨床兒科雜志》2017年05期

【摘要】：目的探討EVI1基因表達與兒童急性髓細胞白血病(AML)臨床表現(xiàn)及預后的關系。方法檢測AML患兒EVI1基因表達,分析EVI1陽性AML患兒臨床和實驗室檢查特點以及預后。結果 145例AML患兒中EVI1陽性38例,占26.21%。與陰性組相比,陽性組患兒的年齡、性別、血紅蛋白量、白細胞及血小板計數(shù)、細胞形態(tài)學FAB分型、異常核型檢出率差異均無統(tǒng)計學意義(P0.05);陰性組復雜核型檢出率高于陽性組,差異有統(tǒng)計學意義(χ2=5.50,P=0.019)。38例陽性患兒中,14例化療與7例異基因造血干細胞移植(allo-HSCT)患兒的無事件生存(EFS)率差異有統(tǒng)計學意義(χ2=4.00,P=0.045)。陽性組與陰性組患兒化療完全緩解率差異無統(tǒng)計學意義(91.67%對91.18%,P0.05),陽性組患兒復發(fā)率高于陰性組,差異有統(tǒng)計學意義(64.29%對22.22%,P=0.009);兩組EFS率差異也有統(tǒng)計學意義(χ2=5.76,P=0.015)。2例陽性組患兒骨髓復發(fā)時EVI1基因仍陰性。結論 EVI1基因是兒童AML的不良預后因素,allo-HSCT可改善EVI1陽性AML患兒預后。定量檢測EVI1基因表達可能不適用于微小殘留病監(jiān)測。
[Abstract]:Objective to investigate the relationship between EVI1 gene expression and clinical manifestation and prognosis of childhood acute myeloid leukemia (AML). Methods the expression of EVI1 gene was detected in AML children. The clinical and laboratory features and prognosis of AML patients with EVI1 positive AML were analyzed. Results among 145 AML children, 38 cases were EVI 1 positive, accounting for 26.21%. There was no significant difference in age, sex, hemoglobin content, white blood cell and platelet count, cell morphological FAB typing, abnormal karyotype detection rate between the positive group and the negative group (P 0.05), but the detection rate of complex karyotype in the negative group was higher than that in the positive group. The difference was statistically significant (蠂 ~ 2 / 5.50 / P ~ (0.019) P ~ (0.019) among 38 positive children (14 / 38) and 7 (n = 7) allo-HSCT patients with allo-HSCT. There was a significant difference in EFSs (蠂 ~ (2 +) 4.00 / P ~ (0.045) in children with hematopoietic stem cell transplantation (HSCT). There was no significant difference in the complete remission rate of chemotherapy between the positive group and the negative group (91.67% vs 91.18%, P 0.05). The recurrence rate of the positive group was higher than that of the negative group. The difference was statistically significant (64.29% vs 22.22%, P < 0.009), and the difference of EFS rate between the two groups was also statistically significant (蠂 2 + 5.76%, P < 0.015.2). The EVI1 gene was still negative in the patients with bone marrow recurrence in the positive group. Conclusion EVI1 gene is a poor prognostic factor in childhood AML. Allo-HSCT can improve the prognosis of children with EVI1 positive AML. Quantitative detection of EVI 1 gene expression may not be suitable for minimal residual disease monitoring.
【作者單位】： 重慶醫(yī)科大學附屬兒童醫(yī)院兒童醫(yī)院兒科研究所兒童發(fā)育疾病研究教育部重點實驗室兒科學重慶市重點實驗室;
【基金】：重慶市衛(wèi)生計生委醫(yī)學科研項目(No.2015msxm042)
【分類號】：R733.71

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