摘要目的 探讨黑色素瘤优先表达抗原(preferentially expressed antigen of melanoma,PRAME)基因转录本在急性髓系白血病(acute myeloid leukemia,AML)患者中的表达和临床意义.方法 建立荧光染料EvaGreen实时定量聚合酶链反应(real-time quantitative PCR,RQ-PCR)对56例初诊AML患者和20例对照的骨髓单个核细胞标本中PRAME转录本进行检测,分析其临床相关性.结果 PRAME转录本含量在对照组和AML患者中分别为0～1.46%(中位0.18%)和0～21 618.09%(中位9.79%)(P＜0.01);FAB亚型中M1、M2、M3和M4患者中PRAME转录本含量较对照组明显增高,而M5患者与对照组差异无统计学意义.PRAME转录本含量与染色体预后分组显著负相关(r=-0.438,P=0.001),低危组患者中PRAME转录本含量显著高于中危组和高危组患者.AML-M2患者中t(8;21)易位阳性者PRAME转录本含量(135.06%～21 618.09%,中位2 201.88%)明显高于无t(8;21)易位者(0.14%～1696.30%,中位17.97%)(P=0.002).对1例AML患者不同阶段的标本检测发现诱导缓解后PRAME转录本明显下降,复发时又明显升高.结论 PRAME转录本在AML患者中高表达,是患者预后良好的一个标记,可用于AML患者的随访监测.

abstractsObjective To analyze the expression level and clinical significance of the preferentially expressed antigen of melanoma (PRAME) transcripts in patients with acute myeloid leukemia (AML).Methods Real-time quantitative polymerase chain reaction with EvaGreen dye was established to detect the expression level of PRAME transcripts in the bone marrow mononuclear cells of 56 AML cases and 20 controls. The clinical association of PRAME transcripts was analyzed. Results The PRAME transcripts were 0-1. 46% (median 0. 18%) and 0-21 618. 09% (median 9. 79%) in controls and AML cases,respectively (P＜0.01). Among the FAB subtypes, those with M1, M2, M3 and M4 had significantly higher level of PRAME transcripts than controls. However, those with M5 had similar level of PRAME transcripts as controls. There was a significantly negative correlation between the PRAME transcripts and cytogenetic risk groups (r= -0. 438, P= 0. 001). Cases in low risk had significantly higher level of PRAME transcripts than those in intermediate and high risk. Among cases with AML-M2, those with t(8;21) had significantly higher level of PRAME transcripts (135.06%-21 618.09%, median 2201.88%) than those without t(8;21) (0. 14%-1696.30%, median 17. 97%)(P=0. 002). In a patient with sequential samples, PRAME transcripts significantly decreased after induction therapy and significantly increased after relapse. Conclusion The PRAME transcript was highly expressed in AML patients and was a favorable marker of prognosis. Quantification of PRAME transcript can be used in monitoring disease status of AML.