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p 1INK4B  在多发性骨髓瘤中的临床病理意义和潜在药物靶标


 

Authors Li J, Bi L, Lin Y, Lu Z, Hou G

Published Date October 2014 Volume 2014:8 Pages 2129—2136

DOI http://dx.doi.org/10.2147/DDDT.S71088

Received 13 July 2014, Accepted 26 August 2014, Published 31 October 2014

Approved for publication by Professor Shu-Feng Zhou


Abstract: Multiple myeloma (MM) is a clonal malignancy characterized by the proliferation of malignant plasma cells in the bone marrow and the production of monoclonal immunoglobulin. In addition to genetic changes, gene hypermethylation is an alternative mechanism of tumor suppressor gene inactivation in MM. The cyclin-dependent kinase inhibitor 1 (CDKN2B  or p15 INK4B ) gene lies adjacent to the tumor suppressor gene, cyclin-dependent kinase inhibitor 2 (CDKN2A ), and is frequently mutated and deleted in a wide variety of tumors, including MM. However, there is a lack of systematic analysis of p15  epigenetic modification such as methylation in MM from different studies that can provide more powerful estimation of an effect. In this study, we have systematically reviewed the studies of p15 INK4B  promoter methylation in MM and quantified the association between p15 INK4B  promoter methylation and MM using meta-analysis methods. We observed that the frequency of p15 INK4B  methylation is significantly higher in MM patients than in normal healthy controls. The pooled odds ratio (OR) from ten studies including 394 MM and 99 normal individuals is 0.08, while confidence interval (CI) is 0.03–0.21 (<0.00001). This indicates that p15 INK4B  inactivation through methylation plays an important role in the pathogenesis of MM. In addition, the frequency of p15 INK4B  methylation was significantly higher in patients with MM than in those with asymptomatic monoclonal gammopathy of undetermined significance. The pooled OR from four studies is 0.40, 95% CI =0.21–0.78 (=0.007). These results suggest that silencing of p15 INK4B  gene expression by epigenetic modification such as promoter hypermethylation plays a role not only in the initiation of MM but also in plasma cell malignant transformation, disease progression, and development.

Keywords: multiple myeloma, asymptomatic monoclonal gammopathy of undetermined significance (MGUS), p15 , methylation, meta-analysis