WT1基因突变与急性髓系白血病预后关系的Meta分析

Relationship between WT1 gene mutation and prognosis of acute myeloid leukemia:a Meta-analysis

目的分析总结WT1基因突变与急性髓系白血病(AML)预后的关系。方法检索PubMed、Google Scholar及Cochrane Library数据库截至2018年4月2日收录的相关文献,采用Review Manager 5.2软件进行Meta分析。结果共纳入9篇文献。Meta分析结果显示,对于儿童AML患者,WT1基因突变型组较野生型组总生存(OS)时间更短(HR=1.41,95% CI 1.07~1.87,P=0.01)。对于总体AML患者,WT1基因突变型组较野生型组无复发生存(RFS)时间更短(HR=2.21,95% CI 1.15~3.93,P=0.02),而两组OS及无病生存(DFS)时间差异均无统计学意义(HR=1.65,95% CI 0.97~2.80,P=0.06;HR=0.46,95% CI 0.08~2.57,P=0.38)。对于正常核型AML及成年AML患者,WT1基因突变型组与野生型组OS时间差异均无统计学意义(HR=2.66,95% CI 0.57~12.31,P=0.21;HR=2.10,95% CI 0.70~6.30,P=0.18)。结论WT1基因突变是影响儿童AML患者OS及总体AML患者RFS的危险因素。

Objective To summarize the relationship between WT1 gene mutation and prognosis of acute myeloid leukemia (AML).Methods The related literatures were searched in PubMed,Google Scholar and Cochrane Library databases,and the deadline was April 2,2018.The Meta-analysis was performed by using Review Manager 5.2 software.Results A total of 9 literatures were included.Meta analysis showed that for the pediatric AML patients,the overall survival (OS) time in the WT1 gene mutated group was shorter than that in the wild-type group (HR=1.41,95% CI 1.07-1.87,P=0.01).For the total AML patients,the relapse-free survival (RFS) time in the WT1 gene mutated group was shorter than that in the wild-type group (HR=2.21,95% CI 1.15-3.93,P=0.02),but there was no significant difference in OS and disease-free survival (DFS) time between the two groups (HR=1.65,95% CI 0.97-2.80,P=0.06;HR=0.46,95% CI 0.08-2.57,P=0.38).For the AML patients with normal karyotype and adult AML patients,there was no difference in OS time between the WT1 gene mutated group and wild-type group (HR=2.66,95% CI 0.57-12.31,P=0.21;HR=2.10,95% CI 0.70-6.30,P=0.18).Conclusion WT1 gene mutation is a risk factor affecting OS of pediatric AML patients and RFS of general AML patients.