E2F3a gene expression has prognostic significance in childhood acute lymphoblastic leukemia
E2F3a gene expression has prognostic significance in childhood acute lymphoblastic leukemia
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E2F3a基因表达在儿童急性淋巴细胞白血病中具有预后意义
DOI：
10.1111/ejh.12341
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发表时间：
2014-10-01
影响因子：
3.1
通讯作者：
Li, Zhi-Gang
中科院分区：
文献类型：
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作者：
Wang, Kai-Ling;Mei, Yan-Yan;Li, Zhi-Gang
目的探讨E2 F3 a在急性淋巴细胞白血病（ALL）患儿中的表达及其临床意义。在测试队列（n=48）中，使用受试者工作特征（ROC）曲线来找到将患者分为E2 F3 a低表达组和高表达组的最佳截止点。E2 F3 a表达的预后意义在测试队列中进行了研究，并在验证队列中得到证实（n=100）。结果ROC曲线分析显示E2 F3 a表达的最佳临界值为0.3780。在测试队列中，低表达组的无白血病生存期（LFS）和无事件生存期（EFS）低于高表达组（对数秩：P=0.026）。这一发现在验证队列中得到了验证。低表达组的LFS、EFS和总生存期也低于高表达组（对数秩，P分别为0.015、0.008和0.002）。E2 F3 a低表达与BCR-ABL融合基因的存在有关。由E2 F3 a表达和微小残留病（MRD）组成的算法可以比当前的风险分层更准确地预测复发或诱导失败。结论E2 F3 a低表达与儿童ALL预后不良有关。E2 F3 a表达和MRD组成的算法可以更准确地预测复发或诱导失败，比目前的危险分层。
ObjectivesTo study E2F3a expression and its clinical significance in children with acute lymphoblastic leukemia (ALL).MethodsWe quantified E2F3a expression at diagnosis in 148 children with ALL by real-time PCR. In the test cohort (n=48), receiver operating characteristic (ROC) curve was used to find the best cut-off point to divide the patients into E2F3a low- and high-expression groups. The prognostic significance of E2F3a expression was investigated in the test cohort and confirmed in the validation cohort (n=100). The correlations of E2F3a expression with the clinical features and treatment outcome of these patients were analyzed.ResultsROC curve analysis indicated that the best cut-off point of E2F3a expression was 0.3780. In the test cohort, leukemia-free survival (LFS) and event-free survival (EFS) of the low-expression group were lower than those of the high-expression group (log rank: P=0.026 for both). This finding was verified in the validation cohort. LFS, EFS, and overall survival were also lower in the low-expression group than in the high-expression group (log rank, P=0.015, 0.008, and 0.002 respectively). E2F3a low expression was correlated with the existence of BCR-ABL fusion. An algorithm composed of E2F3a expression and minimal residual disease (MRD) could predict relapse or induction failure more precisely than current risk stratification. These results were still significant in the ALL patients without BCR-ABL fusion.ConclusionsLow expression of E2F3a was associated with inferior prognosis in childhood ALL. An algorithm composed of E2F3a expression and MRD could predict relapse or induction failure more precisely than that of the current risk stratification.