Objective: To detect the relative expression of IGLL1 (immunoglobulin lambda-like polypeptide 1) mRNA in bone marrow of children with T-cell acute lymphoblastic leukemia (T-ALL), and analyze its correlation with the clinical characteristics and prognosis of the patients, so as to clarify the clinical significance of IGLL1 in pediatric T-ALL patients.
Methods: A total of 56 pediatric T-ALL patients hospitalized in Children's Hospital of Soochow University from June 2012 to December 2017 and treated with CCLG-ALL 2008 regimen were selected. Transcriptome sequencing technology was used to detect the transcription level of IGLL1 gene in children with T-ALL. According to 25% of the IGLL1 transcription level (cutoff value:448), the enrolled children were divided into IGLL1 low expression group (17 cases) and IGLL1 high expression group (39 cases). Combined with clinical data, the correlation between the expression level of IGLL1 and prognosis of the patients was analyzed.
Results: The comparative analysis showed that the transcription level of IGLL1 was not correlated with the clinical characteristics of the patients, such as sex, age, bone marrow blast, white blood cell (WBC) count at initial diagnosis. The 5-year OS rate of patients with high IGLL1 expression was significantly higher than that of patients with low IGLL1 expression (76.9%±6.7% vs 47.1%±12.1%, P =0.018). Further comparison of relapse-free survival (RFS) rate between the two groups showed that the 5-year RFS rate of patients with high IGLL1 expression was higher than that of patients with low IGLL1 expression, but the difference between the two groups was not statistically significant (P =0.095). Multivariate COX analysis was conducted on common clinical prognostic factors (age, sex, WBC count at diagnosis, prednisone response on the 7th day, bone marrow response on the 15th day after treatment) and IGLL1 expression level, and the results showed that IGLL1 expression (P =0.012) and prednisone response (P =0.017) were independent risk factors for overall survival in pediatric T-ALL patients.
Conclusion: In pediatric T-ALL, the OS rate of children with high expression of IGLL1 gene was significantly higher than that of children with low expression of IGLL1 gene, and the expression level of IGLL1 gene was an independent factor affecting the survival of children with T-ALL, which suggests that IGLL1 is a marker of good clinical prognosis of children with T-ALL.
题目: IGLL1基因在儿童T-ALL中的表达及临床意义.
目的: 检测儿童T系急性淋巴细胞白血病（T-ALL）患者骨髓标本中 IGLL1（immunoglobulin lambda-like polypeptide 1）mRNA的相对表达量，并与儿童T-ALL的临床特征及预后进行相关分析，明确 IGLL1在儿童T-ALL中的临床意义。.
方法: 选取2012年6月至2017年12月期间就诊于苏州大学附属儿童医院的初诊T-ALL且接受CCLG-ALL 2008方案治疗的患儿56例。采用转录组测序技术检测T-ALL患儿中 IGLL1基因的转录水平，按照 IGLL1转录水平的25%（cutoff value:448）将患儿分为 IGLL1低表达组（17例）和 IGLL1高表达组（39例）。结合临床资料，分析 IGLL1在T-ALL患儿中的表达水平与预后的相关性。.
结果: IGLL1的转录水平与患儿性别、年龄、骨髓原始细胞数、初诊白细胞（WBC）数等临床特点没有相关性， IGLL1高表达组患者较 IGLL1低表达组患者5年总生存率明显提高（76.9%±6.7% vs 47.1%±12.1%，P =0.018）。进一步比较 IGLL1高表达患者与低表达患者的无复发生存率（RFS），发现 IGLL1高表达组患者5年无复发生存率要高于 IGLL1低表达组（80.6%±6.6% vs 54.9%±14.0%），但两组间无复发生存率差异无统计学意义（P =0.095）。将临床常见预后因素（年龄、性别、初诊WBC计数、强的松D7th治疗反应、治疗后D15th骨髓反应情况）及 IGLL1表达水平进行多因素COX分析，结果显示， IGLL1表达量（P =0.012）和强的松治疗反应（P =0.017）是影响儿童T-ALL患者总体生存的独立危险因素。.
结论: 在儿童T-ALL中， IGLL1基因高表达组患儿的总生存率明显高于低表达组患儿，且 IGLL1基因表达水平是影响儿童T-ALL患者生存的独立因素，提示 IGLL1是儿童T-ALL患儿临床预后良好的指标。.
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