白血病患者WT1基因表达及其临床意义

Expression of Wilms' Tumor Gene (WT1) and Its Clinical Significance in Patients with Leukemia

目的:探讨WT1基因在白血病中表达情况与临床意义。方法:采用筑巢式逆转录聚合酶链反应(NestRT-PCR)检测K562白血病细胞系、78例急性白血病(AL)患者、10例慢性粒细胞白血病(CML)患者和22例正常对照骨髓或外周血细胞的WT1基因表达。结果:60例初治或复发AL中有44例患者高表达WT1基因,阳性率73.3%。在急性非淋巴细胞白血病(ANLL)和急性淋巴细胞白血病(ALL)阳性率分别为70.8%和83.3%,两组无显著性差异。随着WT1基因表达水平的升高,完全缓解(CR)率有明显下降的趋势,CR后WT1基因表达水平明显下降,复发后又显著升高。结论:用NestRT-PCR测定WT1基因的表达可用作检测白血病微小残留病(MRD)的一项指标。

Objective： To evaluate the expression of the WT1 gene and its clinical significance in patients with leukemia. Methods：Expression of WT1 was measured in 78 patients with acute leukemia, among which 10 were patients with CML and 22 were normal controls, using nested RT-PCR. Results： The expression of WT1 increased in 44 of the 60 patients with leukemia, and the positive rate was 73.3%. The positive rate for the WT1 gene in acute myeloid leukemia and acute lymphocytic leukemia was 70.8% and 83.3%, respectively. No significant difference was found between these two groups. The CR rate was markedly decreased as WT1 gene expression level increased. Short-term follow-up showed that WT1 gene expression level was markedly decreased after CR, but highly increased after relapse. Conclusion： Monitoring of the WT1 gene by nested RT-PCR would be a useful marker for the detection of minimal residual disease （MRD） in acute leukemia.