儿童急性白血病WT1和bcl-2基因的表达及意义

目的研究急性白血病患儿WT1和bcl-2基因表达情况及其相关性，探讨两者与儿童急性白血病发病机制和预后的关系。方法应用逆转录．聚合酶链反应（RT-PCR）方法测定56例急性白血病患儿及12例对照患儿的WT1基因表达，同时采用免疫荧光流式细胞术观察40例急性淋巴细胞白血病（ALL）患儿抗凋亡基因bcl-2的表达。结果56例急性白血病患儿中38例WT1基因表达阳性，较对照组明显为高（P＜0．01）；在ALL和急性髓系白血病（AML）患儿WT1基因表达阳性率分别为65．96％和77．78％，差别没有统计学意义（P＞0．05）；WT1表达阳性患儿的完全缓解率（CR）低于表达阴性患儿（P＜0．05）。40例ALL患儿中bcl-2高表达28例，较对照组明显为高（P＜0．01）；AML患儿的bcl-2表达与WT1基因表达正相关（Pearson相关系数为0．262）；bcl-2高表达患儿CR低于低表达患儿（P＜0．05）；联合WT1及bcl-2表达情况将ALL患儿分为高危、中危和低危三组，其CR率分别为33．33％、72．73％和100％，三组间差异有显著性（P＜0．05）。结论WT1基因和bcl-2表达与儿童急性白血病的发病和预后密切相关；WT1基因及bcl-2的共同表达情况可作为预测ALL患儿预后的重要指标。

Expression and significance of WT1 and bcl-2 genes in children with acute leukemia

Objective To study the expression of WT1 and bcl-2 genes in children with acute leukemia and the correlation between them,and explore the relationship among the WT1 and bcl-2 genes expression,the pathogenesis and prognosis of childhood acute leukemia.Methods Expression of WT1 was measured in 56 acute leukemia children and 12 control children by RT-PCR method.Expression of bcl-2 was measured in 40 ALL children by immunofluorescence flow cytometry.Results Expression of WT1 was revealed in 38 of 56 acute leukemia children.The positive rate of WT1 was higher than that in control children(P<0.01).The positive rate for the WT1 gene in ALL and AML was 65.96 % and 77.78 %,respectively.No significant difference was found between them(P<0.01).Complete remission rate was lower in WT1 positive children than that in WT1 negative children(P<0.05).The bcl-2 expression in 28 of 40 ALL children was high-positive,and the bcl-2high-positive rate was higher than that in control children(P<0.01).Positive correlation was showed between the expression of WT1 and bcl-2 in ALL children,and the Pearson coefficient correlation was 0.262.Complete remission rate was lower in bcl-2 high-positive children than that in bcl-2 low-positive children(P<0.05).Forty ALL children were divided into high-,intermediate-,and low-risk groups according to the expression of WT1 and bcl-2.CR rates were significantly different among these 3 groups(33.33 % for high-,72.73 % for intermediate-,and 100 % for low-risk group,P<0.05).Conclusion The expression of WT1 and bcl-2 was correlated with the pathogenesis and prognosis of childhood acute leukemia,and the coexpression of WT1 and bcl-2 predicts poor prognosis of ALL children.