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目的研究WT1基因在急性白血病(AL)患者骨髓细胞中的表达及其临床意义。方法采用实时定量RT-PCR方法动态检测92例初治AL患者WT1基因的表达。结果初治AML各亚型中M5基因表达阳性率最高,为91.7%,其WT1基因中位表达水平最高,达1308.6,显著高于其他亚型,差异有统计学意义(P<0.05);初治ALL各亚型(L1,L2,L3)之间WT1基因表达阳性率及中位表达水平差异无统计学意义(P>0.05);AL患者中,WT1基因表达阳性组CR率显著低于阴性组,阳性组缓解后半年内复发率显著高于阴性组,差异均有统计学意义(均P<0.05);初治组、复发组及未缓解组AL患者骨髓细胞WT1基因中位表达水平明显高于完全缓解组和对照组,差异有统计学意义(P<0.05)。结论WT1基因在AL患者骨髓细胞中表达水平可作为临床评估疾病的发生发展、判断预后及检测微小残留病(MRD)的指标。
Objective To study the expression of WT1 gene in bone marrow cells of patients with acute leukemia (AL) and its clinical significance. Methods The real-time quantitative RT-PCR method was used to detect the expression of WT1 gene in 92 newly diagnosed AL patients. Results The positive rate of M5 gene in the newly diagnosed AML subtypes was the highest (91.7%). The highest expression level of WT1 gene was 1308.6, which was significantly higher than other subtypes (P <0.05) There was no significant difference in the positive rate and the median expression level of WT1 gene among ALL subtypes (L1, L2, L3) (P> 0.05). In AL patients, the CR rate of WT1 gene positive group was significantly lower than negative The recurrence rate in six months after remission in the positive group was significantly higher than that in the negative group (all P <0.05). The median expression of WT1 gene in the bone marrow cells of the AL group was significantly higher than that of the untreated group Higher than the complete remission group and the control group, the difference was statistically significant (P <0.05). Conclusion The expression level of WT1 gene in bone marrow cells of patients with AL can be used as a clinical evaluation of disease development, prognosis and detection of minimal residual disease (MRD).