| Objective: The expression of hypoxia-inducible factor-1 alpha(HIF-1?)and platelet-derived growth factor B(PDGF-B)in bone marrow of patients with MDS was detected,and the survival of MDS patients were collected to analyze the clinical significance in MDS prognosis.Methods: The expression of HIF-1? mRNA and PDGF-B mRNA in 89 patients with MDS and 30 normal controls were detected by fluorescence real-time RT-PCR(q RT-PCR),and follow-up data were collected by reviewing patients' medical records and by telephoning,to analyze its relationship with clinical data and prognosis in MDS patients.Result:(?)Expression of HIF-1? mRNA in bone marrow cells of MDS patients1.The expression of HIF-1? mRNA in 89 patients with MDS(2.66±1.69)was significantly higher than that in control group(0.86±0.49),the difference was statistically significant(P <0.001).2.According to the World Health Organization classification of MDS,the expression levels of HIF-1? mRNA in 7 cases of RA/RARS/5q-,33 cases of RCMD,26 cases of RAEB1 and 23 cases of RAEB2 were 1.82±0.90,1.93±1.21,3.03±1.92,3.52±1.71,there was significant difference between these groups(P=0.001).The expression of HIF-1? mRNA of RAEB1/RAEB2 group(3.26± 1.83)was significantly higher than that in RA/RARS/5q-/RCMD(1.91±1.15,P<0.001).The expression of HIF-1? mRNA in MDS patients was positively correlated with WHO classification and bone marrow blasts(r=0.403,P<0.001;r=0.376,P<0.001).3.Chromosomal karyotype analysis was performed for 72 patients with MDS,the expression of HIF-1? mRNA in 41 karyotype-abnormal patients(3.13±1.73)was significantly upregulated than that in 31 karyotype-normal patients(1.91±1.16,P=0.001).Based on prognosis,the expression of HIF-1?mRNA in patients with good prognosis group,moderate prognosis group,poor prognosis group were 1.90±1.13,2.89±1.73,3.39±1.76,the difference was statistically significant(P=0.003).The expression of HIF-1? mRNA in MDS patients was positively correlated with chromosome karyotype prognosis(r=0.397,P=0.001).4.The expression of HIF-1? mRNA in 42 FISH-abnormal patients(3.21±1.91)was significantly higher than that in 34 FISH-normal(1.87±1.07,P<0.001).5.The International Prognostic Scoring System(IPSS)was performed for74 MDS patients,the expression of HIF-1? mRNA in low-risk group,intermediate-1 risk group,intermediate-2 risk group,high-risk group were1.66±0.94,1.94±1.37,3.09±1.83,4.29±1.57,the difference was obviously statistically significant(P<0.001).The expression of HIF-1? mRNA in patients with moderate-high group(3.46±1.82)was significantly higher than that in low-risk group(1.92±1.34,P <0.001).The expression of HIF-1? mRNA in MDS patients was positively correlated with IPSS score(r=0.491,P<0.001).6.Survival analysis was collected on 81 MDS patients,38 survived and 43 died.The median survival time of 31 MDS patients with high expression of HIF-1? mRNA was 300 days.The median survival time of 50 patients with low expression of HIF-1? mRNA was 990 days.The difference between the two groups was statistically significant(P <0.001).(?).The expression of PDGF-B in MDS bone marrow cells of MDS patients1.The expression of PDGF-B mRNA in 89 MDS patients(2.10±2.22)was significantly higher than that in 30 normal controls(0.62±0.47,P <0.001).2.According to the WHO classification in MDS patients,the expression levels of PDGF-B mRNA in 7 cases of RA/RARS/5q-,33 cases of RCMD,26 cases of RAEB1 and 23 cases of RAEB1/RAEB2 were 1.31±1.22,1.48±0.97,1.83±1.19,3.55±3.64,the difference between the groups was statistically significant(P=0.002).The expression of PDGF-B mRNA in the RAEB1/RAEB2 group(2.64±2.75)was significantly higher than that in the RA/RARS/5q-/RCMD group(1.45±1.01,P=0.007).The expression of PDGF-B mRNA in MDS patients was positively correlated with WHO classification(r=0.286,P=0.007).3.The expression level of PDGF-B mRNA in 41 patients with chromosomal abnormalities(2.50±1.72)was significantly higher than that in 32 normal subjects(1.28±0.94,P<0.001)in 72 patients with chromosomal karyotype analysis.According to the prognosis of chromosome karyotype,the expression of PDGF-B mRNA in patients with good prognosis group,moderate prognosis group,poor prognosis group were 1.29±0.93,2.40±2.10,2.65±1.51,the difference between the groups was statistically significant(P=0.001).The expression of PDGF-B mRNA in MDS patients was positively correlated withchromosome karyotype prognosis(r=0.440,P<0.001).4.In 76 MDS patients with FISH-diagnosed,the expression of PDGF-B mRNA in 42 patients with FISH-abnormal(2.33±1.77)was significantly higher than that in 34 patients with FISH-normal(1.38±0.95,P=0.004).5.The expression levels of PDGF-B mRNA in bone marrow of patients in moderate-high risk group were significantly higher than those in low-moderate group(2.50±1.93vs1.59±1.16,P=0.016),according to IPSS prognosis score.The expression of PDGF-B mRNA in 2 cases of low-risk,33 patients in intermediate-1 risk group,27 cases of intermediate-2 risk and 12 patients in high-risk group were 0.73±0.37,1.65±1.17,1.86±1.30,3.94±2.37,the difference was statistically significant(P=0.010).There was a positive correlation between PDGF-B mRNA expression and IPSS prognosis score in MDS patients(r=0.391,P=0.001).(?).The expression of HIF-1? mRNA was positively correlated with the expression of PDGF-B mRNA(r=0.402,P<0.001)by Spearman correlation analysis.Conclusion:1.The expression of HIF-1? and PDGF-B mRNA in bone marrow cells of MDS patients were significantly higher than those in normal control group.2.The expression of HIF-1? mRNA and PDGF-B mRNA in patients with RAEB1/RAEB2 were higher than those with RA/RARS/5q-/ RCMD,indicating that HIF-1? and PDGF-B genes may be related to MDS disease progression.3.The median survival time of patients with high expression of HIF-1?mRNA was significantly lower than that of patients with low expression of HIF-1? mRNA,indicating that HIF-1? was associated with the prognosis of patients with MDS,and the high expression of HIF-1? indicated poor prognosis.4.There was a positive correlation between the expression of HIF-1?mRNA and the expression of PDGF-B mRNA in MDS patients,suggesting that HIF-1? may be related to the increase of PDGF-B expression in MDS patients. |
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