急性白血病患儿黑色素瘤特异性抗原基因的表达及与WT1基因的比较  

Expression of Preferentially Expressed Antigen of Melanoma Gene in Children with Acute Leukemia and Its Clinical Applications Compared with WT1 Gene

作　　者：聂莹[1] 潘凯丽[1] 刘安生[2] 

机构地区：[1]第四军医大学西京医院儿科,西安710032 [2]西安市儿童医院血液科,西安710032

出　　处：《实用儿科临床杂志》2010年第15期1161-1164,共4页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨急性白血病(AL)患儿骨髓及外周血单个核细胞(MNC)中黑色素瘤特异性抗原(PRAME)基因表达及用于微小残留病监测的可行性。方法采用反转录-聚合酶链反应(RT-PCR)方法检测51例AL患儿[未缓解组40例,其中ALL29例,急性髓细胞性白血病(AML)11例;缓解组11例]PRAMEmRNA的表达情况。同期与WT1mRNA表达进行比较。设立20例非恶性血液系统疾病患儿骨髓标本、5例健康成人外周血标本作为阴性对照。结果未缓解组17例(42.5%)可检测出不同水平PRAME基因表达,其中ALL组与AML组的表达率(41.4%vs45.5%)、表达水平[(1.0966±0.4033)vs(1.0641±0.4274)]比较差异均无统计学意义(Pa>0.05)。缓解组与对照组均未检测出PRAME基因表达。6例初发患儿外周血MNC中PRAMEmRNA表达水平(0.5531±0.4786)与骨髓中表达水平(0.5755±0.6853)一致,差异无统计学意义(P>0.05)。34例初发患儿总完全缓解(CR)率为88.2%(30例),其中初诊时PRAME、WT1基因表达均为阳性和均为阴性组CR率(62.5%vs100%)比较差异有统计学意义(P<0.05)。短期随访(1～13个月)2例WT1基因阳性和2例PRAME、WT1均表达阳性的患儿,2例化疗达CR时,PRAME、WT1基因表达水平均下降,并逐渐转阴。另外2例第1疗程化疗结束未达临床缓解,PRAME、WT1基因持续高水平表达,放弃治疗。结论应用RT-PCR方法跟踪监测PRAME基因表达,可在一定程度上了解体内白血病细胞负荷,有助于指导治疗,可用于微小残留病的监测。Objective To explore the expression of preferentially expressed antigen of melanoma（PRAME）gene in children with acute leukemia bone marrow （BM） and peripheral blood（PB）,mononuclear cellular and its clinical significance for monitoring minimal residual disease.Methods The expression of PRAME mRNA was detected in 40 non-remission samples,11 remission samples and control group of 20 BM samples of non-malignant disease children,5 PB samples of healthy donors by using reverse transcripase-polymerase chain reaction（RT-PCR）,and compared with the expression of WT1 gene.Results Overexpression of PRAME mRNA was found in 17 of 40 cases （42.5%） in non-remission group.None was found in control group.In ALL group and AML group,PRAME mRNA expression rate were 41.4%,45.5%,there was no significant difference （P〈0.05）.The expression level of PRAME mRNA in BM（0.575 5±0.685 3）and PB（0.553 1±0.478 6）was similar,there were no statistical significant difference （P〉0.05）.Thirty-four cases of newly diagnosed children with CR rate was 88.2% （30 cases）.Which the expression of PRAME gene,WT1 gene were both positive and negative groups of children with CR rates were 62.5% and 100.0%,there was no significant difference between the 2 groups（P〈0.05）.Short follow-up（1-13 months） observed 2 WT1-positive children and 2 cases with the expression of PRAME,WT1 gene children.Two cases achieved complete remission,the expression of PRAME gene and WT1 gene decreased and gradually turned negative.Another 2 cases below the first course of treatment to alleviate,PRAME gene and WT1 gene continued overexpression,gave up treatment.Conclusions Using RT-PCR detect PRAME expression at a certain extent could be a useful tool for monitoring minimal residual disease in children with acute leukemia.

关 键 词：微小残留病 黑色素瘤特异性抗原基因 WT1基因 反转录聚合酶链反应 儿童 

分 类 号：R733.71[医药卫生—肿瘤]