急性白血病患者PRAME、WT1基因表达及其临床意义

Expression and clinical significance of PRAME and WT1 gene in patients with acute leukemia

目的探讨急性白血病患者PRAME、WT1基因的表达临床意义及其与疾病分型的关系。方法所西南医科大学附属医院白血病初发患者58例,包括急性髓系白血病(AML)患者36例,急性淋巴细胞白血病(ALL)22例;AL完全缓解组(CR)20例,为同期血液科门诊白细胞或血小板正常或轻度减少,骨髓一致正常人20例为对照,采用Real-time PCR方法对PRAME、WT1基因的表达进行检测。结果初治组患者的PRAME、WT1相对表达量均显著高于缓解组和对照组(P<0.05),但缓解组和对照组比较差异无统计学意义(P>0.05),跟踪11例白血病初治患者,诱导化疗缓解后两种基因的相对表达量均显著低于诱导化疗前(P<0.05),WT1阳性表达率为70.7%(41/58),PRAME阳性表达率为56.9%(33/58)。结论PRAME、WT1基因联合检测可提高阳性率,可用于监测白血病患者的微小残留病(MRD),并且PRAME、WT1基因的表达与白细胞的发生、疾病的分型密切相关,对白血病患者的化疗、预后判断以及监测微小病灶具有一定的意义。

Objective To investigate the clinical significance of PRAME and WT1 gene expression in acute leukemia and its relationship with disease classification. Methods 58 leukemia patients from The Affiliated Hospital of the Medical College of South- west were selected, including 36 acute myeloid leukemia （AML） patients and 22 acute lymphoblastic leukemia （ALL） cases; and 20 complete remission （CR） cases, for the same period in the outpatient department of Hematology of white cells and platelets with normal or slightly reduced, consistent with normal bone marrow 20 cases were selected as control group. The expression of PRAME and WT1 were detected by Rea! - time PCR. Results The expression of PRAME and WT1 in untreated patients were significantly higher than those in the remission group and the control group （P 〈 0.05 ） , but the remission group and the control group had no significant difference （P 〉 0.05 ） ; After remission induction chemotherapy in 11 cases of leukemia patients, the expression of two genes was significantly lower than before （ P 〈 0.05 ） , the positive expression rate of WT1 was 70.7% （41/58） , the positive expression rate of PRAME was 56.9% （ 33/58 ）. Conclusion PRAME and WT1 detection could improve the positive rate, and could be used for monitoring leukemia patients with minimal residual disease （MRD） ; The PRAME, WT1 gene expression were closely related with leukocyte occurrence and disease subtypes, and has a certain significance in leukemia chemotherapy, prognosis and monitoring of small lesions.