| Objective: The expression level of apoptosis-prone protein(CAS/CSE1L)in bone marrow of newly treated patients with acute leukemia(AL)was detected and its interaction protein was searched by bioinformatics software,and the relationship between CAS/CSE1 L and clinical characteristics and post-treatment remission of AL patients was analyzed.To investigate the clinical significance and mechanism of CAS/CSE1 L in acute leukemia.Methods: 1.CAS/CSE1 L protein was systematically analyzed by NCBI,GEPIA,Prot Param,Protscale,PSORT II,SOPMA,SWISS-MODEL,STRING and other software.2.A total of 57 AL patients were collected and treated in the hematology department of the Second Hospital of Shanxi Medical University from November 2020 to May 2021,including 45 patients with AML and 12 patients with ALL.Bone marrow samples from 22 cases with non-hematological tumor in the hematology Department of the control group were selected.The expression of CAS/CSE1 L was detected by flow cytometry(FCM).Based on the clinical data of the patients,including gender,age,height,weight,blood routine,biochemistry,bone marrow morphology,risk stratification,etc.,the correlation between the difference in CAS/CSE1 L expression level and the above clinical characteristics was analyzed.Results: 1.GEPIA database showed that CAS/CSE1 L was expressed in both normal and tumor tissues,but the expression levels were different between them.2.The analysis of CAS/CSE1 L is as follows: Prot Param software shows that the protein is an acidic protein and is an unstable protein.Protscale software results show that the protein is a hydrophilic protein,which is more than two-thirds distributed in the cytoplasm,followed by the nucleus,α-helix is its main structure.After entering CSE1 L in STRING software,set high confidence(0.900)and the number of proteins not exceeding 10 for analysis,and obtain 10 proteins with physical or chemical interactions and indirect interactions with CSE1 L,which are as follows: EFS,IPO4,IPO5,KPNA1,KPNA2,KPNA3,KPNA4,KPNB1,RAN and XPO1.3.CAS/CSE1 L expression levels of baseline AML and ALL were remarkble higher than in the remarkble group,and the differ was widely significant(P value was 0.000 and 0.032,respectively).There was no significant difference in CAS/CSE1 L between AML and ALL(P=0.147).4.In AML,the high or low expression of CAS/CSE1 L was related to the proportion of bone marrow blast cells,risk stratification,and complete response rate after the first treatment(all P<0.05),and was not related to other clinical features such as age,sex,BMI,WBC,Hb,PLT,FIB,ALB,LDH,etc.(all P>0.05).In ALL,the high or low expression of CAS/CSE1 L was related to the proportion of blast cells in the bone marrow and the complete response rate after the first treatment(P<0.05),and not to risk stratification,age,sex,BMI,WBC,Hb,PLT,FIB,ALB,LDH,etc.(all P>0.05).5.The expression of CAS/CSE1 L in AML patients after treatment was 10.52%(6.10%,18.68%)compared with 43.09%(29.95%,57.37%)of the initial treatment(Z=-5.969,P=0.000).After treatment,the expression of CAS/CSE1 L in ALL patients was significantly reduced by 4.77%(2.36%,13.99%)compared with 23.98%(15.27%,44.08%)of the initial treatment(Z=-2.483,P=0.013).6.After 1 course of induction chemotherapy,the complete response rate between the CAS/CSE1 L high and low expression groups in AML was different(x2=5.836,P=0.016),and the CAS/CSE1 L expression level in the complete response group was 5.77%(1.81%,9.72%)significantly lower than that of the 14.76%(9.86%,31.39%)group without complete response,and the difference was statistically significant(Z=-3.500,P=0.000).There was a difference in complete response rate between the high and low expression groups of CAS/CSE1 L in ALL(x2=4.083,P=0.043).There was no statistically significant difference between CAS/CSE1 L expression levels in the complete response group and the incomplete response group in the ALL group(Z=-1.074,P>0.05),but the CAS/CSE1 L expression level in the complete response group was lower than in the incomplete response group.6.CAS/CSE1 L evaluated the critical value of complete response in AL patients after one course of chemotherapy was 13.32%,and the area under ROC curve was 0.79(95%CI: 0.666 ~ 0.916,P = 0.001).7.CAS/CSE1 L assessed AML patients with a cut-off value of 13.32% for complete response after 1 course of chemotherapy,and the area under the ROC curve was 0.853(95% CI: 0.733 ~0.972,P=0.000).8.Comparing CAS/CSE1 L in the AML group with MRD was statistically significant(x2=5.978,P=0.014).Conclusion: 1.The expression of CAS/CSE1 L in bone marrow of AL patients is higher than that of non-hematological tumor patients,and the decrease of CAS/CSE1 L in AL patients after treatment suggests that CAS/CSE1 L has potential value as a therapeutic target for AL;2.The expression level of CAS/CSE1 L in the bone marrow of patients with AML is related to risk stratification and complete remission after 1 course of induction chemotherapy,and the expression level in the bone marrow of patients with ALL is related to complete remission after 1 course of induction chemotherapy,suggesting that CAS/CSE1 L expression may be associated with prognosis and is a negative factor in prognosis;3.It is consistent with MRD,so CAS/CSE1 L is expected to be a biological test to judge the response and prognosis of AML patients to treatment. |
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