急性白血病患者血清中期因子定量检测及其临床意义

目的 探讨血清中期因子(MK)水平在急性白血病(AL)不同发展阶段的意义及其与WT1基因的关系.方法 用酶联免疫吸附实验(ELISA)检测86例初治和完全缓解的AL患者组及30名健康对照血清中MK水平;用实时定量PCR法检测其中15例初治急性髓系白血病(AML)患者骨髓细胞中WT1表达量.结果 初治组血清MK水平(中位数及四分位数)为7.52 ng/ml[(5.44,10.55)ng/ml],缓解组MK水平为3.52 ng/ml[(1.56,5.20) ng/ml],健康对照组MK水平为2.44 ng/ml[(1.89,3.12)ng/ml],初治组较缓解组和健康对照组水平均升高,差异有统计学意义(P＜0.01),缓解组和健康对照组间MK水平差异无统计学意义(P＞0.05).初治B细胞急性淋巴细胞白血病(B-ALL)组血清MK水平为7.88 ng/ ml[(5.78,15.78) ng/ml],初治AML中MK水平为6.25 ng/ml[(4.59,16.33) ng/ml],两组间差异无统计学意义(P＞0.05);血清MK水平与骨髓中WT1基因表达量间存在相关性(r=0.529,P=0.043).结论 初治AL患者血清中MK表达水平升高,完全缓解后MK表达水平下降,ELISA法测定血清MK可以作为AL患者病情评价的手段之一;MK与WT1在基因定位上相邻,临床意义相近,并且血清MK和WT1基因在定量上存在相关性.

The quantitative measurement of midkine in serum of patients with acute leukemia and its clinical significance

Objective To explore the meaning of midkine (MK) levels in serum in different development stage of acute leukemia,and to explore the relationship between MK and WT1.Methods The levels of the MK in serum of 86 cases of acute leukemia and 30 cases of normal people were detected by ELISA.Real-time quantitative PCR (RQ-PCR) method was used to determine the expression of WT1 at mRNA level in 15 AML patients.Results The MK level in serum in the new diagnosed group was higher than that in the complete remission group and the normal control group [7.52 (5.44,10.55) ng/ml vs 3.52 (1.56,5.20) ng/ml vs 2.44 (1.89,3.12) ng/ml].There' s no statistical difference between midkine level in new diagnosed acute B cell leukemia (B-ALL) group and acute myeloid leukemia (AML) group [7.88 (5.78,15.78) ng/ml vs 6.25 (4.59,16.33) ng/ml].The clear correlation was found between the level of serum MK and quantities of marrow WT1 gene (r =0.529,P =0.043).Conclusions The level of MK in serum of acute leukemia patients is increased at the time of new diagnosis and decreased at complete remission.ELISA may be a way to measure the status of AL.The location of MK gene is adjacent to WT1 gene and MK' s clinical significance is similar to WT1' s,furthermore,there is a clear correlation between MK in serum and WT1 of marrow in quantities.