急性髓系白血病患者骨髓WT1基因的表达与预后的关系  

Prognostic value of WT1 expression in bone marrow for acute myeloid leukemia

作　　者：万鼎铭[1] 边志磊[1] 刘延方[1] 曹伟杰[1] 张媛[2] 李涛[1,3] 何海燕[1] 玄中乾[1] 

机构地区：[1]郑州大学第一附属医院血液科,郑州450052 [2]新乡医学院第一附属医院血液科,新乡453100 [3]郑州大学血液病研究所,郑州450052

出　　处：《郑州大学学报（医学版）》2014年第3期386-390,共5页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的:探讨急性髓系白血病(AML)患者骨髓WT1基因的表达与预后的关系。方法:应用实时定量逆转录PCR方法检测122例初诊AML患者骨髓WT1基因的表达水平,并进行初次诱导化疗缓解率(CR1)及2 a无白血病生存率(LFS)和总生存率(OS)的分析。对照组为21例非白血病患者或造血干细胞移植健康供者。结果:对照组骨髓WT1基因表达水平为0.007(0.002,0.080);AML组为0.677(0.336,0.763),明显高于对照组(Z=2.620,P<0.001)。AML-M3患者WT1基因高表达组与低表达组CR1、2 a LFS和OS无差异。AML(非M3)患者WT1基因低表达组CR1为82.6%(38/46),高表达组为52.3%(23/44),两组比较,差异有统计学意义(χ2=9.476,P=0.002);两组的总生存曲线和无白血病生存曲线差异有统计学意义(χ2=5.410、4.698,P<0.05),高表达组2 a OS(36.0%)和LFS(33.3%)均低于低表达组(57.7%和53.7%)。结论:骨髓WT1基因表达水平是预测AML预后的有效监测指标。Aim：To investigate the relationship between WT 1 gene expression level in bone marrow of acute myeloid leukemia （ AML） patients and the prognosis .Methods：A total of 122 newly diagnosed AML patients were subjected to de-tect WT1 expression level in bone marrow by real time quantitative reverse transcription-PCR method ,and the complete re-mission rate after the first induction chemotherapy （CR1）, two-year leukemia-free survival rate（LFS） and two-year overall survival rate （ OS） were calculated .A total of 21 cases of non-AML were the control .Results：The median expression level of WT1 in AML patients was 0.677（0.336,0.763）, which was higher than that of control [0.007（0.002,0.080）,Z=2.620,P〈0.001].With regard to AML-M3 patients,CR1, two-year LFS and OS of the patients with high expression level of WT1 was similar to those of the patients with low expression level of WT 1.With regard to non AML-M3 patients, CR1 in the high WT1 expression group was 52.3%, lower than that of 82.6%in the low WT1 expression group （χ2 =9.476,P=0.002）;the two-year leukemia-free survival curve and overall survival curve of high WT 1 expression patients differed from those of low WT1 expression patients（χ2 =4.698,5.410,P〈0.05）,and two-year LFS and OS of high WT1 expression pa-tients were 33.3%and 36.0%,lower than 53.7%and 57.7%of the low WT1 expression patients.Conclusion：WT1 ex-pression level in bone marrow could be an useful prognosis marker for AML patients .

关 键 词：急性髓系白血病 WT1基因 预后 

分 类 号：R557.3[医药卫生—血液循环系统疾病]