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目的:探讨急性髓细胞白血病(acute myeloblastic leukemia,AML)患儿骨髓细胞中Wilms瘤基因1(Wilms tumor gene1,WT1)及其剪接异构体WT1(17AA+)的表达及临床意义。方法:应用实时荧光定量PCR(real-time fluorescence quantitative-PCR,RFQ-PCR)检测112例次AML患儿不同阶段骨髓细胞中WT1和WT1(17AA+)mRNA的相对表达量,计算WT1(17AA+)/WT1的比值,并以同期30例非白血病患儿作为对照。结果:AML初诊组患儿的WT1和WT1(17AA+)mRNA相对表达量均明显高于非白血病对照组及缓解期患儿(P<0.05)。复发组患儿的WT1和WT1(17AA+)mRNA相对表达量与初诊组和耐药组相比,差异无统计学意义(P>0.05)。缓解组患儿的WT1(17AA+)/WT1比值明显低于初诊组、复发组和耐药组(P<0.05)。3例AML患儿的动态监测结果显示,临床耐药或复发患儿的WT1和WT1(17AA+)mRNA相对表达量以及WT1(17AA+)/WT1比值均呈持续高表达,或者表现为一过性下降后的再度上升。结论:WT1及WT1(17AA+)mRNA剪接异构体可能成为判断AML预后及临床治疗疗效的指标。
Objective: To investigate the expression and clinical significance of Wilms tumor gene1 (WT1) and its splicing isoform WT1 (17AA +) in bone marrow cells of children with acute myeloblastic leukemia (AML). Methods: The relative expression of WT1 and WT1 (17AA +) mRNA in different stages of bone marrow cells from 112 children with AML was detected by real-time fluorescence quantitative-PCR (RFQ-PCR) WT1 ratio, and the same period in 30 cases of non-leukemia children as a control. Results: The relative expression of WT1 and WT1 (17AA +) mRNA in AML newly diagnosed group was significantly higher than that in non-leukemia control group and remission children (P <0.05). There was no significant difference in the relative expression of WT1 and WT1 (17AA +) mRNA between the newly diagnosed group and the drug-resistant group (P> 0.05). The ratio of WT1 (17AA +) / WT1 in remission group was significantly lower than that in newly diagnosed group, relapsed group and drug resistant group (P <0.05). The dynamic monitoring results of 3 AML children showed that the relative expression of WT1 and WT1 (17AA +) mRNA and the ratio of WT1 (17AA +) / WT1 in children with clinically drug-resistant or recurrent disease were consistently high or transiently decreased After the rise again. Conclusion: The isomer of WT1 and WT1 (17AA +) mRNA splicing may be an indicator to judge the prognosis of AML and clinical curative effect.