The Expression Of Livin Gene In Leukemia And Its Clinical Significance

Objective:To explore the correlation between the expression of Livin gene in leukemic cells and its clinical significance.Methods:A total of 63 leukemia patients were enrolled into our study. The levels of leukemic cell Livin mRNA in 41 patients with acute leukemia,22 patients with chronic leukemia, and 10 healthy adult controls were measured by using semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) technique.Results:The positive expression rate of leukemic cell Livin mRNA in the AL patients was 53.7%. The positive expression rates of Livin mRNA in ALL cells and ANLL cells were 53.8% and 53.6%, respectively, which were higher than that in normal controls (10.0%) (Fisher's exact method:P=0.035,0.017). The positive expression rates of Livin mRNA in initially treated AL patients and relapsed patients were 52.4% and 85.7%, respectively, which were significantly higher than that in normal controls (Fisher's exact method:P= 0.025,0.0036). The positive expression rate of Livin mRNA in the remission patients (15.4%) was significantly lower than initially treated patients and relapsed patients (Fisher's exact method:P=0.0043,0.0296), but there was no statistical significance as compared with normal controls. Besides, the AL patients with a leukocyte count of at least 50×109/L had a significantly higher Livin mRNA expression rate(80.0%)(8/10) than those with a leukocyte count of less than 50×109/L(35.5%)(11/31)(χ2= 4.368, P< 0.05). In addition, the levels of Livin mRNA in the former were significantly higher than the latter (T=6.5, P< 0.05). Livin mRNA expression levels in ALL, ANLL patients were 0.171(0.102),0.087(0.117), respectively, which were higher than that in normal controls (0.010) (H= 20.22, d= 14.25,14.61, P< 0.05). The positive expression rates of Livin mRNA in CML-CP, CML-AP and CML-BP patients were 8.3%(1/12),75.0%(3/4)and 100.0%(2/2), respectively. The positive expression rates of Livin mRNA in CML-BP and CML-AP patients were significantly higher than that in normal controls (P=0.045,0.040) and CML-CP patients (P=0.033,0.026). There were no significant difference between CML-CP patients and normal controls. Livin mRNA expression levels in CML-CP, CML-AP, CML-BP patients and normal controls were 0.014,0.112(0.096),0.136(0.073) and 0.010, respectively. Livin mRNA expression levels were significantly increased in CML patients in accelerated/blastic phase (AP/BP) as compared to normal controls (H=21.35, d=14.42,15.73, P< 0.05) and patients in chronic phase (CP) (H=20.67, d=13.87,13.72, P<0.05). Livin mRNA was not detected in the 4 CLL patients in our study.Conclusions:Overexpression of Livin gene may play an important role in the pathogenesis of leukemia and may be a risk factor for poor prognosis in AL. High expression of Livin can serve as one of the markers for predicting the relapse and prognosis in AL. The important role of Livin gene expression in the proliferation and differentiation of leukemic cells may be one of the reasons leading to insensitivity to chemotherapy of the leukemic cells, indicating Livin gene can be used as a potential target for targeted treatment of the disease.