Objective To explore the expression and clinical significance of Musashi2 (MSI2)gene in denovo acute myeloid leukemia (AML).Methods Real-time quantitative PCR (RQ-PCR) was used to measure the expression of MSI2 gene in 181 de novo AML patients.Correlation between the expression level and clinical features of such patients was explored.Results Transcript of the MSI2 gene was detected in 181 AML patients,with the median expression level being 2.341 (0.1124-58.8566).By contrast,CD34+ cells from 10 healthy controls had a much lower expression level (P =0.012),and the expression level of MSI2 in 24 patients with complete remission was significant lower than de novo patients (P=0.021).Based on the median expression level,such patients were divided into low expression group and high expression group.Patients from the high expression group had significantly higher rate of high white blood cell count (78％ vs.63％,P =0.034).Compared with MSI2-low group,FLT3-ITD mutation were much more common in MSI2-high group (28％ vs.7％,P=0.002).The expression level of MSI2 in aberrant karyotypes was much higher than that in favorable karyotypes (the median expression level was 2.7726 and 2.0733,P=0.035).Kaplan-Meier analysis showed that the overall survival in high expression group of MSI2 was lower than the low expression group,with the median survival time being 28 months and 12 months,respectively (P=0.045).Conclusion De novo AML patients have a higher level ofMSI2 gene expression.And the latter is much more common in those with high white blood cell count and aberrant karyotypes,and has a positive correlation with FLT3-ITD mutation.High expression of MSI2 gene may be a predictor for poorer prognosis among AML patients.%目的 研究Musashi2(MSI2)基因在成人初发急性髓系白血病(acute myeloid leukemia,AML)患者中的表达及临床意义.方法 应用实时定量PCR(real time quantitative PCR,RQ-PCR)方法检测181例初发AML患者白血病细胞MSI2基因的表达,并收集相关临床和实验室资料进行统计学分析.结果 181例AML患者中均检测到MSI2基因的表达,表达范围0.1124～58.8566,中位表达量2.3141,显著高于10名正常人CD34+细胞MSI2的表达量(P=0.012),且24例完全缓解的AML患者MSI2的表达量较初发时显著下降(P=0.021).以MSI2基因表达量的中位数为界,将AML患者分为高表达和低表达两组,高表达组中高白细胞数患者的比例(78％)显著高于低表达组(63％)(P=0.034),且MSI2基因高表达患者的FL T3-ITD基因突变率较低表达组高(28％ vs.7％,P=0.002).预后不良核型患者MSI2基因的表达显著高于预后良好核型的患者(中位数表达量分别为2.7726和2.0733,P=0.035).生存分析发现MSI2高表达患者的总体生存时间显著差于低表达患者(中位生存时间分别为12个月和28个月,P=0.045).结论 MSI2基因在初发AML中高表达,MSI2基因高表达多见于高白细胞数及核型预后不良的患者,且和高FL T3-TD基因突变率相关,其可能是成人初发AML患者预后不良的指标.
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