白血病细胞检测WT1mRNA及其蛋白产物的价值与意义  

The Value and Significance of Monitoring WT1 mRNA and its Associating Protein in Patients with Leukemia

作　　者：胡永军[1] 滕熔[1] 

机构地区：[1]南通医学院附属医院血液研究室

出　　处：《中国血液流变学杂志》2004年第4期448-451,454,共5页Chinese Journal of Hemorheology

摘　　要：目的　研究WT1同白血病预后的关系及其作为白血病微小残留病检测指标的可行性及实用性。方法　采用逆转录聚合酶联反应及间接免疫荧光方法检测白血病患者及正常人骨髓或外周血单个核细胞WT1mRNA及其蛋白产物。结果　WT1mRNA及其蛋白产物在急性白血病细胞中高表达 ,初诊急性白血病患者WT1mRNA阳性表达 (39例 )较阴性表达 (12例 )治疗完全缓解率 (38.5 % ,83.3% )低 ,急性白血病化疗完全缓解后WT1mRNA阳性表达与阴性表达无病存活率 (15 .4 % ,5 0 .0 % )经Log rank检验有统计学意义。WT1蛋白在急性白血病中的表达率为 5 1.0 % ,表达部位为细胞核 ,在白血病阴性对照组及正常对照组中的表达率为 0。结论　WT1表达同急性白血病预后呈负相关 ,其逆转录聚合酶联反应可作为监测白血病微小残留病一项实用而有价值的方法。Objective To investigate the expressive rate of wilms tumor gene in leukemic cells,determine the relationship between the rate and prognosis,and discuss the feasibility and practibility of this gene acting as one marker of minimal residual disease.Methods Reverse transcription polymerase chain reaction (RT-PCR) and indirec immunofluorescence were established to detect WT1 mRNA and its associating protein in mononuclear cells of bone marrow or peripheral blood in leukemic patients and healthy comparisons.Results There is high expressive rate of WT1 mRNA and its associating protein in acute leukemic patients.The completely remission rate of chemotherapy in newly diagnostic leukemic patients with WT1 positive expression(39 case,38.5%) is lower than the rate with WT1 negative expression(12 case,83.3%).The survival rate between patients with WT1 positive expression (15.4%) and patients with durable negative expression (50.0%) has statistical difference by Log-rank test in 12 months after CR.The expressive rate of WT1 associating protein which is merely expressed in nucleus is 51.0 percent in newly diagnostic leukemias,and the rate is 0 percent both in leukemic negative control group and nomal control group.Conclusions The expression of WT1 has negative correlation to the prognosis,and monitoring WT1 mRNA with RT-PCR can act as one of the practical and valuable methods to detect minimal residual disease in leukemic patients expressing WT1.

关 键 词：WT1 急性白血病 蛋白产物 RNA 阳性表达 完全缓解 阴性 细胞核 表达率 逆转录 

分 类 号：R733.7[医药卫生—肿瘤] R692[医药卫生—临床医学]