张太海,金皎,黄璟,李鹏,吴西军,吴昌学,马健娟,庹媛媛,李燕,杨红兰,潘海新,杨小燕
ZHANG Taihai,JIN Jiao,HUANG Jing,LI Peng,WU Xijun,WU Changxue,MA Jianjuan,TUO Yuanyuan,LI Yan,YANG Honglan,PAN Haixin,YANG Xiaoyan

• 1:铜仁市人民医院儿科
• 2:贵州医科大学附属医院&贵州省儿童医学中心儿童血液肿瘤科
• 3:贵阳市公共卫生救治中心
• 4:贵州医科大学干细胞与组织工程实验中心

摘要(Abstract)：

目的:探讨整合素αM(ITGAM)基因在急性髓细胞白血病(AML)中的表达及临床意义。方法:利用CELL数据库获取临床常见血液肿瘤性疾病数据,并分析ITGAM在不同血液肿瘤中的表达情况;利用基因表达谱数据动态分析(GEPIA)数据库获得AML组173例和健康对照组70例的资料,比较2组对象间ITGAM mRNA表达的差异,同时将AML组分为高表达组(高于均值) 53例和低表达组(低于均值) 53例、分析AML患者ITGAM表达量与其总体生存率(OS)的相关性;利用UALCAN数据库获得AML患者样本171例,分析ITGAM在M0～M7中的表达情况;利用Bloodspot数据库获得AML患者样本172例,分析ITGAM在不同基因突变或染色体异常患者中的表达,同时将AML患者分为ITGAM mRNA高表达组(高于中位数) 86例和低表达组(低于中位数) 86例进行生存分析。结果:与健康对照组相比,ITGAM在AML患者中表达增高(P <0. 05); ITGAM在不同亚型AML中表达水平存在差异,M5中表达最高、M3中表达最低;其中,M4、M5分别与M0比较,M3、M4、M5分别与M1比较,M4、M5分别与M2比较,M4、M5、M7分别与M3比较,ITGAM基因表达差异有统计学意义(P <0. 05),ITGAM在AML t(11q23)/MLL中表达最高、在AML t (15; 17)中表达最低,2组比较差异有统计学意义(P <0. 01); ITGAM在伴有Cepba+_NPM1-_FLT3+突变的AML患者中表达较低,在Cepba-_NPM1-_FLT3-和Cepba-_NPM1+_FLT3-AML患者中表达最高; Kaplan-Meier分析结果表明,ITGAM基因表达与AML患者生存有相关性,高表达ITGAM的AML患者预后差(P=0. 024,P=0. 008)。结论:ITGAM基因在AML患者样本中呈高表达,且ITGAM高表达的AML患者OS差,该基因对预测AML患者预后有一定的临床应用价值。
Objective: To explore the expression and clinical significance of integrin alpha M( ITGAM) in acute myeloid leukemia( AML). Methods: Cancer Cell Line Encyclopedia( CCLE) was used to obtain clinically common hematological tumor data and analyze the expression of ITGAM in the disease. The dynamic analysis of gene expression profile( GEPIA) database was used to obtain 173 cases in the AML group and 70 cases in the healthy control group,and compare the difference of ITGAM mRNA expression between the two groups. AML group was divided into the high expression group( 53 cases above the mean value) and the low expression group( 53 cases below the mean value),and the correlation between ITGAM expression levels and overall survival( OS) of AML patients were analyzed. 171 AML samples were obtained from the UALCAN database to analyze the expression of ITGAM in M0 ～ M7 AML patients. A total of 172 AML samples were obtained from Bloodspot database, and the expression of ITGAM in patients with different gene mutations or chromosome abnormalities was analyzed. Meanwhile,AML patients were divided into the high ITGAM mRNA expression group( 86 cases above the median value) and the low ITGAM mRNA expression group( 86 cases below the median value) for survival analysis. Results: The expression of ITGAM in AML patients significantly increased more than that in the control group,and the difference was statistically significant( P < 0. 05). The difference of ITGAM gene expression was statistically significant( P < 0. 05) in M4 and M5 vs M0 group,M3,M4 and M5 vs M1 group,M4 and M5 vs M2 group,M4, M5 and M7 vs M3 group. ITGAM expression was related to chromosome karyotype abnormalities and mutation types in AML patients. And ITGAM expression was the highest in AML t( 11 q23)/MLL and the lowest in AML t( 15; 17),and the difference was statistically significant( P <0. 01). The expression of AML was lower in patients with Cepba + _NPM1-_FLT3 + mutation,and highest in AML cases with Cepba-_NPM1-_FLT3-and Cepba-_NPM1 + _FLT3-. Kaplan-meier analysis showed that the expression of ITGAM gene was significantly correlated with the survival of AML cases,and the prognosis of AML cases with high expression of ITGAM was worse( P = 0. 024,P = 0. 008).Conclusion: ITGAM gene is highly expressed in AML patients,and high expression of ITGAM is related to worse OS. It has clinical application value for the prognosis of AML patients.

关键词(KeyWords)： 白血病,髓样,急性;基因表达;ITGAM基因;总体生存率;临床意义
leukemia,myeloid,acute;gene expression;ITGAM gene;overall survival rate;clinical significance

Abstract:

Keywords:

基金项目(Foundation): 贵州省科技计划项目[黔科合平台人才(2019)5406，黔科合LG字(2012)009];; 贵州省教育厅青年科技人才成长项目[黔科合KY字(2018)192];; 贵阳市科学与技术局、贵阳市公共卫生救治中心大健康合作项目[筑科合同(2019)9-12-3];; 贵州医科大学2017年度学术新苗培养及创新探索专项[黔科合平台人才(2017)5718)]

作者(Author): 张太海,金皎,黄璟,李鹏,吴西军,吴昌学,马健娟,庹媛媛,李燕,杨红兰,潘海新,杨小燕
ZHANG Taihai,JIN Jiao,HUANG Jing,LI Peng,WU Xijun,WU Changxue,MA Jianjuan,TUO Yuanyuan,LI Yan,YANG Honglan,PAN Haixin,YANG Xiaoyan

DOI: 10.19367/j.cnki.2096-8388.2020.07.007

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