急性髓细胞白血病儿童Wilms瘤基因1及其剪接异构体的表达及临床意义

Expressions of Wilms tumor gene 1 and isoform WT1(17AA+) in children with acute myeloid leukemia and their clinical significance

目的:探讨急性髓细胞白血病(acute myeloblastic leukemia,AML)患儿骨髓细胞中Wilms瘤基因1(Wilms tumor gene1,WT1)及其剪接异构体WT1(17AA+)的表达及临床意义。方法:应用实时荧光定量PCR(real-time fluorescence quantitative-PCR,RFQ-PCR)检测112例次AML患儿不同阶段骨髓细胞中WT1和WT1(17AA+)mRNA的相对表达量,计算WT1(17AA+)/WT1的比值,并以同期30例非白血病患儿作为对照。结果:AML初诊组患儿的WT1和WT1(17AA+)mRNA相对表达量均明显高于非白血病对照组及缓解期患儿(P<0.05)。复发组患儿的WT1和WT1(17AA+)mRNA相对表达量与初诊组和耐药组相比,差异无统计学意义(P>0.05)。缓解组患儿的WT1(17AA+)/WT1比值明显低于初诊组、复发组和耐药组(P<0.05)。3例AML患儿的动态监测结果显示,临床耐药或复发患儿的WT1和WT1(17AA+)mRNA相对表达量以及WT1(17AA+)/WT1比值均呈持续高表达,或者表现为一过性下降后的再度上升。结论:WT1及WT1(17AA+)mRNA剪接异构体可能成为判断AML预后及临床治疗疗效的指标。

Objective：To explore the expressions of Wilms tumor gene 1（WT1） and isoform WT1（17AA＋） in bone marrow cells from children with acute myeloid leukemia（AML） and their clinical significance.Methods：The relative expression levels of WT1 and WT1（17AA＋） mRNAs in bone marrow cells from 112 cases of AML in different disease courses were detected by real-time fluorescence quantitative-PCR.The ratio of WT1（17AA＋）/WT1 was calculated.Thirty non-leukemia children were recruited as the controls.Results：The relative expression levels of WT1 and WT1（17AA＋） mRNAs in newly diagnosed AML children were significantly higher than those in the complete remission（CR）-phase group and the control group（P〈0.05）,while there was no difference among the relapsed,newly diagnosed and drug-resistant groups（P〉0.05）.The ratio of WT1（17AA＋）/WT1 in CR-phase group was significantly lower than those in the newly diagnosed,relapsed and drug-resistant groups（P〈0.05）.The dynamic monitoring of three children with AML revealed that there was a tendency that the relative expression levels of WT1 and WT1（17AA＋） and the ratio of WT1（17AA＋）/WT1 were high or increased again after a transient decrease.Conclusion：WT1 and WT1（17AA＋） may predict the prognosis and therapeutic efficiency for AML.