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目的 探讨P16基因甲基化与儿童急性白血病 (AL)发生、发展及预后的关系。方法 用甲基化敏感性限制性内切酶SacⅡ酶切加PCR技术研究 33例初治儿童AL、15例复发儿童AL及 30例对照组儿童P16基因甲基化情况 ,并观察P16基因甲基化与化疗结果的关系。结果 33例初治AL中有 3例、15例复发AL中有 6例P16基因甲基化 ,对照组 30例均无P16基因甲基化。P16基因甲基化率初治组与对照组比较差异无显著意义 ;复发组高于初治组及对照组。可评价疗效的 31例初治AL中 ,3例甲基化患儿均未缓解 ;2 8例非甲基化患儿中2 3例获完全缓解、3例部分缓解、2例未缓解 ;31例中 ,甲基化阳性者与甲基化阴性者在完全缓解率及总有效率上 ,差别均有显著意义。但多因素分析提示只有初诊时高白细胞计数 (≥ 2 5× 10 9/L)对化疗结果有影响。结论 在儿童AL中 ,P16基因甲基化少见。P16基因甲基化可能成为预测儿童AL复发的指标之一。P16基因甲基化在判断儿童AL化疗疗效上有一定价值 ,但不能作为独立的判断标准。
Objective To investigate the relationship between methylation of P16 gene and the occurrence, development and prognosis of childhood acute leukemia (AL). Methods methylation-sensitive restriction endonuclease SacⅡ digestion plus PCR was used to study the methylation status of P16 gene in 33 children with AL, 15 children with AL and 30 children with control. P16 gene methylation The relationship between chemotherapy and chemotherapy results. Results 33 cases of initial AL in 3 cases, 15 cases of recurrent AL in 6 cases of P16 gene methylation, control group 30 cases without P16 gene methylation. P16 gene methylation rate of naive group compared with the control group was no significant difference; recurrence group was higher than the initial treatment group and the control group. Among the 31 patients with initially diagnosed AL, none of the 3 methylated children were able to be evaluated. Neither two of the 28 unmethylated children were completely relieved, 3 were partly relieved, and 2 were not relieved. 31 Cases, methylation-positive and negative methylation in complete remission rate and total effective rate, the difference was significant. However, multivariate analysis showed that the high white blood cell count (≥25 × 109 / L) only affected the chemotherapy outcome at the time of first visit. Conclusion P16 gene methylation is rare in children with AL. Methylation of P16 may be one of the predictors of AL recurrence in children. P16 gene methylation in the evaluation of children with AL chemotherapy has some value, but not as an independent criterion.