WT1基因在急性白血病患儿中的表达及其临床意义  

Expression of WT1 Gene in Acute Leukemia in Children and Its Clinical Significance

作　　者：王旭莉[1] 柴忆欢[2] 胡绍燕[2] 岑建农[3] 

机构地区：[1]苏州市立医院本部新生儿科,江苏苏州215000 [2]苏州大学附属儿童医院血液科,江苏苏州215006 [3]苏州大学附属第一人民医院江苏省血液病研究所,江苏苏州215000

出　　处：《实用儿科临床杂志》2010年第3期167-169,共3页Journal of Applied Clinical Pediatrics

基　　金：江苏省高校自然基金项目资助课题(06KJB320101)

摘　　要：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 explore the expression of WT1 gene in acute leukemia in children and its clinical significance.Methods The real-time quantitative reverse transcription-polymerase chain reaction method was used to detect the expression level of WT1 gene in 198 children with acute leukemia.Results The medium of WT1 gene in children with acute leukemia was 932.99,but it was 38.50 in control group,and it in patient′s group was significantly higher than that in control group.The medium of WT1 gene in children with ALL was 195.73,while the medium of WT1 gene in children with acute myeloid leukemia was 6 297.75,and there was significant difference between the 2 groups（P〈0.01）,and its expression levels of FAB type M3,M4（the medium were 8 081.83 and 8 123.54,respectively） were relatively higher in children with AML.There were higher expression levels of WT1 gene in children with acute leukemia in newly diagnosed group and the relapse group（medium of WT1 gene were 932.99 and 2 840.54,respectively）,but the expression levels of WT1 gene decreased obviously in complete remission group（medium of WT1 gene was 144.32）;In 97 cases of children with acute leukemia who could be assessed by clinical efficacy,significant difference existed in WT1 gene expression levels between the complete remission group after the first course of treatment and non-remission group in newly diagnosed,their medium were 311.98 and 3 768.43,respectively.Dynamic monitoring WT1 gene expression level in 3 cases of recurrence children indicated that expression level of WT1 gene before relapse showed a upward trend.Conclusions It suggests that high expression level of WT1 gene of bone marrow exist in children with all types of acute leukemia,and dynamic monitoring of WT1 gene expression level can help to understand the development of acute leukemia,in order to provide a basis for disease recurrence.As a ＂pan-leukemia＂ logo,WT1 gene can be used for minimal residual disease detection.

关 键 词：WT1基因 白血病 急性 实时定量反转录聚合酶链反应 儿童 

分 类 号：R733.71[医药卫生—肿瘤]