急性非淋巴细胞白血病患者 p53基因突变观察

摘要

Objective To explore the mutations of p53 gene and its relationships to chemother-apeutic effect and survival in patients with acute non-lymphoblastic leukemia(ANLL).Methods The mutations of p53 gene were detected by PCR and sequencing in 45 ANLL patients.Clinical and laboratory indexes were compared between patients with p53 mutations and patients without p53 mutations.Results Among the 45 ANLL patients,p53 mutations were found in 6(13.3%). There were no significant differences in the gender,age,leukocyte count and platelet count be-tween patients with p53 mutations and patients without p53 mutations at initial diagnosis(P >0.05).The complete remission rate in patients with p53 mutations was significantly lower than that in patients without p53 mutations(P =0.022),and the overall survival in patients with p53 mutations was significantly shorter than that in patients without p53 mutations(P =0.000).Con-clusion Patients with p53 mutations have low remission rate,short survival,and poor response to remission induction chemotherapy.The mutations of p53 gene are closely correlated with the prognosis of ANLL.%目的：观察急性非淋巴细胞白血病（ANLL）中 p53基因突变情况及其与化疗疗效、患者生存期的关系。方法应用聚合酶链式反应及测序检测45例初诊 ANLL 患者 p53基因突变情况，分析比较 p53突变组与无突变组患者的临床及实验室指标。结果45例 ANLL 患者中6例检测到 p53基因突变，突变率为13．3％。2组患者初诊时的年龄、性别、外周血白细胞计数及血小板计数差异均无统计学意义（P ＞0．05）。突变组患者诱导缓解化疗的CR 率明显低于无突变组（P ＝0．022），OS 明显短于无突变组（P ＝0．000）。结论p53基因突变患者对诱导缓解化疗反应差、缓解率低、生存期短；p53基因突变与 ANLL 患者的预后密切相关。