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目的探讨WT1基因在急性白血病患儿中的表达及其临床意义。方法采用实时定量RT-PCR方法检测198例急性白血病患儿(男124例,女74例;年龄1~13岁)WT1基因的表达水平。应用SPSS 13.0软件进行统计学分析。结果急性白血病患儿WT1基因的中位数为932.99,对照组儿童为38.50,病例组显著高于对照组;ALL患儿WT1基因的中位数为195.73,AML患儿WT1基因的中位数为6 297.75,ALL患儿与急性髓性白血病(AML)患儿之间存在统计学差异(P<0.01),且在AML患儿FAB分型中M3、M4表达水平相对较高(中位数分别为8 081.83和8 123.54);WT1基因在急性白血病初诊组及复发组患儿中表达水平较高(WT1基因中位数分别为932.99和2 840.54),而完全缓解组表达水平显著下降(WT1基因中位数为144.32);可进行临床疗效评估的97例急性白血病患儿中,第1个疗程后完全缓解组与未缓解组初诊WT1基因表达水平差异有统计学意义,其中位数分别为311.98和3 768.43;对3例复发患儿进行WT1基因表达水平动态监测,发现复发前WT1的表达水平均有上升趋势。结论WT1基因在各类急性白血病患儿骨髓中呈高表达水平,动态监测WT1基因的表达可了解急性白血病的发展,为疾病的复发提供依据。WT1基因作为一个“泛白血病”标志,可用于微小残留病的检测。
Objective To investigate the expression of WT1 gene in children with acute leukemia and its clinical significance. Methods The expression of WT1 gene in 198 cases of acute leukemia (124 males and 74 females; aged 1 to 13 years old) was detected by real-time quantitative RT-PCR. SPSS 13.0 software was used for statistical analysis. Results The median of WT1 gene in children with acute leukemia was 932.99 and that in the control group was 38.50, the case group was significantly higher than that of the control group. The median of WT1 gene in ALL children was 195.73. The median of WT1 gene in children with AML was 6 297.75 There was a significant difference between children with ALL and children with acute myeloid leukemia (AML) (P <0.01), and the levels of M3 and M4 were higher in children with AML Which were 8 081.83 and 8 123.54 respectively). The WT1 gene was highly expressed in the newly diagnosed and relapsed children with acute leukemia (median WT1 gene was 932.99 and 2 840.54 respectively), while the level of expression in the complete remission group was significantly decreased (WT1 gene The median was 144.32). Among the 97 acute leukemia patients who could evaluate the clinical efficacy, there was a significant difference in the expression of WT1 gene between the first complete remission group and the non-remission group after the first course of treatment, with the median of 311.98 And 3 768.43 respectively. Dynamic monitoring of WT1 gene expression in 3 children with recurrent disease showed that the expression level of WT1 had an increasing trend before relapse. Conclusion The WT1 gene is highly expressed in the bone marrow of children with various types of acute leukemia. The dynamic monitoring of the expression of WT1 gene can understand the development of acute leukemia and provide a basis for the relapse of the disease. WT1 gene as a “leukemia” mark, can be used for the detection of minimal residual disease.