Wilms肿瘤基因在骨髓增生异常综合征与急性白血病患者骨髓细胞中的表达及其临床意义  

Expression and clinical significance of WT1 in bone marrow cells of patients with myelodysplastic syndrome and acute leukemia

作　　者：华海应[1,2] 高华强[1] 朱文艳[1] 孙爱宁[2] 岑建农[2] 吴丽丽[2] 

机构地区：[1]南通大学第三附属医院血液病科,江苏省214041 [2]苏州大学附属第一医院血液病科

出　　处：《江苏医药》2015年第20期2394-2396,共3页Jiangsu Medical Journal

基　　金：江苏省中医药局基金(LZ09103)

摘　　要：目的研究Wilms肿瘤基因(WT1)在骨髓增生异常综合征(MDS)及急性白血病(AL)患者骨髓细胞中的表达及其临床意义。方法采用qRT-PCR检测62例MDS(MDS组)、157例AL(AL组)和38例非恶性血液病患者(对照组)骨髓细胞中WT1的表达。结果 MDS组WT1阳性率低于AL组(27.4%vs.79.0%)(P<0.01);对照组无WT1阳性表达。MDS组内难治性血细胞减少伴单系发育异常/难治性贫血伴环状铁粒幼红细胞(RCUD/RARS)型、难治性血细胞减少伴多系发育异常(RCMD)型、难治性贫血伴原始细胞增多Ⅰ型(RAEB-1型)和RAEB-2型WT1阳性率分别为9.1%、20.0%、35.3%和57.1%,组间均有统计学差异(P<0.01);AL组内急性髓细胞性白血病(AML)型和急性淋巴细胞性白血病(ALL)型WT1阳性率分别为80.8%和71.9%(P>0.05)。AL患者中,WT1阳性组化疗后的完全缓解率低于WT1阴性组(P<0.05),且半年内复发率高于WT1阴性组(P<0.05)。结论 WT1在MDS及AL患者骨髓细胞中表达水平可作为临床评估疾病的发生发展、预后及检测微小残留病的指标。Objective To study the expression and clinical significance of Wilms＇ tumor gene（WT1）in bone marrow cells of patients with myelodysplastic syndrome（MDS）or acute leukemia（AL）.Methods WT1 expression in bone marrow cells was detected by qRT-PCR method in 62 cases with MDS（group MDS）,157 cases with AL（group AL）and 38 cases without malignant hematological diseases（group C）.Results The positive rate of WT1 expression was lower in group MDS than that in group AL（27.4% vs.79.0%）（P〈0.01）.There was no positive WT1 expression in group C.In group MDS,the positive rates of WT1 expression were 9.1%,20.0%,35.3% and 57.1%,respectively for RCUD/RARS,RCMD,RAEB-1and RAEB-2（P〈0.01）.In group AL,the positive rates of WT1 expression were 80.8% and 71.9%,respectively for AML and ALL（P〉0.05）.In AL patients,complete remission rate was significantly lower and the relapse rate of 6 months after remission was higher in the cases with positive WT1 expression than those with negative WT1expression（P〈0.05）.Conclusion WT1 expression in bone marrow cells in the patients with MDS and AL can be a marker in evaluating the occurrence,development and prognosis and detecting the minimal residual diseases.

关 键 词：Wilms肿瘤基因 骨髓增生异常综合征 急性白血病 

分 类 号：R733[医药卫生—肿瘤]