白血病患者WT1基因表达及其临床意义

目的:探讨WT1基因在白血病中表达情况与临床意义。方法:采用筑巢式逆转录聚合酶链反应(NestRT-PCR)检测K562白血病细胞系、78例急性白血病(AL)患者、10例慢性粒细胞白血病(CML)患者和22例正常对照骨髓或外周血细胞的WT1基因表达。结果:60例初治或复发AL中有44例患者高表达WT1基因,阳性率73.3%。在急性非淋巴细胞白血病(ANLL)和急性淋巴细胞白血病(ALL)阳性率分别为70.8%和83.3%,两组无显著性差异。随着WT1基因表达水平的升高,完全缓解(CR)率有明显下降的趋势,CR后WT1基因表达水平明显下降,复发后又显著升高。结论:用NestRT-PCR测定WT1基因的表达可用作检测白血病微小残留病(MRD)的一项指标。

Expression of Wilms'''' Tumor Gene (WT1) and Its Clinical Significance in Patients with Leukemia

Objective: To evaluate the expression of the WT1 gene and its clinical significance in patients with leukemia. Methods: Expression of WT1 was measured in 78 patients with acute leukemia, among which 10 were patients with CML and 22 were normal controls, using nested RT-PCR. Results: The expression of WT1 increased in 44 of the 60 patients with leukemia, and the positive rate was 73.3%. The positive rate for the WT1 gene in acute myeloid leukemia and acute lymphocytic leukemia was 70.8% and 83.3%, respectively. No significant difference was found between these two groups. The CR rate was markedly decreased as WT1 gene expression level increased. Short-term follow-up showed that WT1 gene expression level was markedly decreased after CR, but highly increased after relapse. Conclusion: Monitoring of the WT1 gene by nested RT-PCR would be a useful marker for the detection of minimal residual disease (MRD) in acute leukemia.