白血病患者Prame基因的表达及其与WT1基因比较的临床意义

目的：探讨Prame(黑色素瘤特异性抗原)在白血病患者中的表达及其临床意义。方法：应用逆转录—聚合酶链反应(RT—PCR)测定58例白血病患者Prame mRNA的表达，并与WTl mRNA的表达相比较。结果：急性髓细胞性白血病(AML)患者Prame阳性表达率为52．2％，急性淋巴细胞性白血病(ALL)患者Prame阳性表达率为66．7％，慢性粒细胞性白血病(CML)急性变患者Prame阳性表达率为55．6％；慢性及加速期CML患者ll例、l0名正常人外周血及l0例非血液病患者骨髓细胞均未见Prame mRNA表达，其中l例AML和5例ALL患者Prame阳性而WT1阴性。对2例Prame阳性和4例Prame、WTl均阳性的患者短期随访发现所有患者化疗后Prame均有不同程度的下降。l例复发患者Prame表达再次升高且早于WTl l个月，余3例白血病患者Prame和WTl表达的波动呈正比。结论：免疫抗原Prame是白血病的一个重要标记基因，与病程进展密切相关，有望成为白血病微小残留病灶检测和进行白血病免疫治疗的靶基因。

Expression of Prame gene in leukemia and its clinical significance compared with WT1 gene

Objective: To explore the expression of Frame gene, an immunogenic antigen, in leukemia and its clinical significance. Method Expression of Frame mRNA was detected in 23 AML,15 ALL, 20 CML patients by using RT-PCR and compared it with the expression of WT1 gene. Result:Frame mRNA was revealed in 12 of 23 AML(52. 2%), 10 of 15 ALLC66. 7%) , 5 of 9 CML patients in blast crisis,none is found in 10 non-blood disease patients and 10 healthy subjects. However, one AML, 5 ALL patients with Frame expression had no WT1 detectable. 2 Frame-positive patients and 4 patients with the both expression in Frame and WT1 genes were monitored in short follow-up. The lowed level of Frame was detected in all patients after chemotherapy. One relapsed patient turned up WT1 expression one month later than the expression of increased Frame. Conclusion:Immunogenic antigen Frame is a special gene expressed in leukemia. It involeved in human leukemogeneses, thus it may be a good tumor marker for monitoring MRD in patients with leukemia. In addition,Frame may also be useful as a target antigen for immunotherapy of leukemia.