白血病患者WT1基因表达的研究

目的：探讨WT1基因与白血病发病的关系和临床意义。方法：采用逆转录－巢式聚合酶链反应（RT－巢式PCR）方法检测了K562和HL－60两个白血病细胞系、49例急性白血病（AL）患者、33例慢性髓系白血病（CML）患者和25例正常对照的WT1基因表达。结果：K562和HL－60两个白血病细胞系、29例初治或复发AL患者中有21例、20例完全缓解（CR）期AL中有1例、18例CML急变期中有15例、5例CML加速期中有1例、10例CML慢性期患者中有1例表达WT1基因。WT1基因表达见于所有AL亚型，其相对水平与急性白血病的CR率有相关性。≥1．0的患者CR率低及生存期短。在CML中WT1基因表达表现出明显的阶段性，与慢性粒细胞白血病临床阶段及病情进展有关。结论：WT1基因表达与白血病发生有关，WT1基因高表达的患者CR率低、无病生存期短，可作为判断急性白血病预后和监测微量残留病的一项指标，也可作为CML急变的一项诊断指标。

Studies of WT1 gene expression in leukemia patients

OBJECTIVE: To explore the expression of WT1 gene in leukemia patients and its clinical implications. METHODS: Expression of WT1 mRNA was detected in two leukemia cell lines (K562 and HL-60), 49 acute leukemia (AL) patients, 33 chronic myeloid leukemia (CML) patients and 25 healthy subjects by reverse trans-criptase-nested polymerase chain reaction (RT-Nested PCR). RESULTS: WT1 gene was expressed in all subtype of AL including K562 and HL-60 cell lines, 21/29 newly diagnosed and relapsed AL patients, 1/20 complete remission (CR) AL patients, 15/18 CML blastic crisis patients, 1/5 CML patients in accelerated phase, and 1/10 CML patients in chronic phase. WT1 gene was undetectable in 25 healthy subjects. The expression level of WT1 gene was related to the prognosis of AL, patients with relative level >/= 1.0 had lower CR rates and disease-free survival. For CML patients, WT1 gene expression was associated with the clinical phase, it increased with disease progressed. CONCLUSION: WT1 gene expression is associated with pathogenesis of leukemia. It is a prognostic factor and a marker for the detection of minimal residual disease in AL and may used as an indicator for diagnosing CML blastic crisis.