中国全科医学2025，Vol.28Issue(27)：3391-3398,8.DOI:10.12114/j.issn.1007-9572.2023.0541
急性T淋巴细胞白血病β-肾上腺素受体的表达情况及临床意义研究
Expression of β-Adrenergic Receptors in Acute T-cell Lymphoblastic Leukemia and Its Clinical Significance
摘要
Abstract
Background β-adrenergic receptors(β-AR)have been closely associated with the occurrence and progression of certain tumors.However,the expression of β-AR in acute T-cell lymphoblastic leukemia(T-ALL)and its correlation with the prognosis and risk stratification of T-ALL have not been reported domestically or internationally.Objective To clarify the expression of β-AR on the leukemic cells of pediatric T-ALL patients and to analyze the impact of β-AR on the risk stratification and prognosis of T-ALL patients.Methods Database searches were conducted to determine the expression levels of β1-AR,β2-AR,and β3-AR in leukemia and other malignant tumors,as well as the influence of their expression levels on tumor prognosis,with data summarized accordingly.Clinical data and bone marrow specimens were collected from 40 pediatric T-ALL patients treated at the Affiliated Hospital of Zunyi Medical University from 2019 to 2022,divided into newly diagnosed T-ALL group and T-ALL remission group based on diagnosis and therapeutic outcomes,with 23 and 17 cases respectively;15 cases of clinical data and bone marrow specimens from pediatric patients with non-hematological diseases were collected as a control group.The newly diagnosed T-ALL group was further divided into intermediate-risk subgroup(9 cases)and high-risk subgroup(14 cases).Additionally,the newly diagnosed T-ALL group was categorized based on prognosis outcomes into a poor prognosis subgroup(10 cases)with death and relapse,and a good prognosis subgroup(13 cases)with good therapeutic effect and complete remission.Clinical data of the pediatric patients were collected.β-AR expression in T-ALL cells was detected using Western blot.Pearson correlation analysis or Spearman rank correlation test was used to explore the correlation between β-AR and the degree of risk in T-ALL pediatric patients.Multifactorial Logistic regression analysis was used to explore the risk factors for high risk in T-ALL pediatric patients.Results Database search results revealed that β1-AR has a higher expression level in prostate cancer,β2-AR has a higher expression level in hematological and prostate-related malignant tumors,and β3-AR has a very low expression level in malignant tumors.Compared with normal blood tissue,the expression of β-AR genes in acute myeloid leukemia blood tissue is higher,mainly dominated by β2-AR gene expression,followed by β1-AR gene,while the expression level of β3-AR gene is lower.The β1-AR gene can affect the survival rate of patients with cervical cancer,squamous cell carcinoma of the lung,pancreatic cancer,sarcoma,and melanoma;the β2-AR gene can affect the survival rate of patients with renal cell carcinoma,adenocarcinoma of the lung,and thymic carcinoma;the β3-AR gene can affect the survival rate of patients with renal clear cell carcinoma.Western blot results showed that the protein expression levels of β1-AR,β2-AR,and β3-AR in the newly diagnosed T-ALL group were higher than those in the control group and T-ALL remission group(P<0.05).The β3-AR in the high-risk subgroup was higher than that in the intermediate-risk subgroup(P<0.05).Multifactorial Logistic regression analysis showed that an increase in β3-AR(OR=7.036,95%CI=1.244-39.783,P=0.027)and the presence of leukemic cells in the bone marrow after 15 days of chemotherapy(OR=10.667,95%CI=1.035-109.941,P=0.047)are risk factors for high risk in T-ALL pediatric patients,and an increase in β3-AR(OR=8.447,95%CI=1.557-45.819,P=0.013)is a risk factor for poor prognosis in T-ALL pediatric patients.Correlation analysis results showed that β2-AR is positively correlated with white blood cell count,the proportion of leukemic cells in the bone marrow at the first diagnosis,and the bone marrow leukemic cells after 15 days of chemotherapy,and β3-AR is positively correlated with the risk and prognosis of T-ALL pediatric patients(P<0.05).Conclusion There is an abnormally high expression of β-AR on the leukemic cells of T-ALL pediatric patients,and the decrease in the expression level of β-AR can be used as an indicator of remission in T-ALL pediatric patients.In addition,the abnormally high expression of β3-AR is an independent risk factor for the occurrence of high risk and poor prognosis in T-ALL pediatric patients.关键词
白血病,T细胞/β-肾上腺素受体/儿童/预后Key words
Leukemia,T-cell/β-adrenergic receptor/Child/Prognosis分类
医药卫生引用本文复制引用
徐艳朋,黄佩,张平平,罗艳,施晓琪,吴柳松,陈艳,何志旭..急性T淋巴细胞白血病β-肾上腺素受体的表达情况及临床意义研究[J].中国全科医学,2025,28(27):3391-3398,8.基金项目
国家自然科学基金资助项目(82260036) （82260036）
教育部协同创新中心建设项目(教科技厅函[2020]39号) （教科技厅函[2020]39号）
贵州省科技计划项目(黔科合基础-ZK[2024]一般300) （黔科合基础-ZK[2024]一般300）
贵州省卫生健康委科学技术基金项目(gzwkj2025-086) （gzwkj2025-086）
