WT1基因在白血病中的表达及临床意义.docVIP

WT1基因在白血病中的表达及临床意义 WT1基因在白血病中的表达及临床意义 2011-05-10 刘云鹏　张敬东　卢香兰　曲秀娟　田昕　崔明　翟明 【摘　要】　目的　探讨WT1基因在白血病中的作用。方法　用定量RT-PCR方法检测病人外周血或骨髓单个核细胞WT1 mRNA表达。结果　50例白血病患者中，41例WT1 mRNA表达增高，阳性率为82.0%。急性髓细胞白血病(AML)和急性淋巴细胞白血病(ALL)阳性率分别为84.0%和93.8%，两组无显著差异(P0.05)，慢性粒细胞白血病(CML)的WT1 mRNA阳性率为66.7%，其中慢性期均阴性，加速期和急变期均阳性。17例完全缓解患者中，15例(85.2%)WT1 mRNA转阴，复发患者WT1 mRNA再次升高。结论　WT1 mRNA表达的测定对白血病微小残留病检测具有重要意义。 【关键词】　白血病　基因，肾母细胞瘤　微小残留病　预后 Clinical significance of Wilms gene(WT1) expression in patients with leukemia Liu Yunpeng，Zhang Jingdong，Lu Xianglan，et al (Department of Hematology，The 1st Affliated Hospital of China Medical University，Shenyang，110001) 【Abstract】　Objective　To evaluate the role of WT1 gene in leukemia.Methods　The expression of WT1 mRNA in peripheral blood or bone marrow cells was detected by RT-PCR method.Results　The expression of WT1 mRNA increased in 41 of 50 patients with leukemia，and the positive rate was 82.0%. The WT1 mRNA positive rates in acute myeloid leukemias and acute lymphoblastic leukemias were 84.0% and 93.8%,respectively，and there was no significant difference between the two groups(P0.05).The WT1 positive rate in chronic myeloid leukemia was 66.7%，in which the WT1 was negative in patients at chronic phase，but positive in both accelerated phase and blast crisis.WT1 mRNA became negative in 15 of 17(85.2%) patients achieving complete remission，but it increased again in the relapsed patients.Conclusion　WT1 mRNA is an important molecular marker for detection of minimal residual disease in leukemia. 【Key words】　Leukemia　Gene，Wilms tumor　Minimal residual disease(MRD)　Prognosis 　　WT1基因是在儿童Wilms肾肿瘤基因研究过程中发现的转录调节基因［1］。由于部分Wilms肾肿瘤的发生与WT1基因变异有关，通常将野生型WT1基因归类于抑癌基因。但是，近年来的研究证明，野生型WT1基因mRNA在70%～100%的急性白血病患者中过度表达，并且在白血病预后判断和微小残留病检测中具有重要意义［1～3］。为进一步探讨WT1在白血病中的作用，我们对50例白血病患者的WT1 mRNA表达进行了RT-PCR检测，报告如下。 1　对象和方法 1.1　研究对象　均为我院门诊或住院患者，共50例。其中男31例，女19例，中位年龄38岁，按FAB诊断、分型标准，急性白血病患者41例，其中急性髓细胞白血病(AML)26例：M13例，M2a6例，M3b2例，M4b1例，M4EO1例，M5a5例，M5b6例，M61例；急性淋巴细胞白血病(ALL)(L2)型16例。慢性粒细胞白血病(C