WT1基因联合FCM-MRD预测急性髓系白血病早期复发的临床研究  

WT1 gene combined with FCM-MRD in predicting early recurrence of acute myeloid leukemia

作　　者：杨威 陈尚萍[1] 张雄[1] 王艳丽[1] 龚燕玲[1] 古茂群[1] 董颖[1] 王思敏 Yang Wei;Chen Shangping;Zhang Xiong;Wang Yanli;Gong Yanling;Gu Maoqun;Dong Ying;Wang Simin(Department of Hematology,Maoming People's Hospital,Maoming,Guangdong 525000,China)

机构地区：[1]茂名市人民医院血液内科,广东茂名525000

出　　处：《现代临床医学》2020年第4期246-248,共3页Journal of Modern Clinical Medicine

基　　金：茂名市科技计划项目(180323151700393)。

摘　　要：目的:探讨WT1基因联合FCM-MRD预测急性髓系白血病(AML)早期复发的临床价值。方法:选取2014年12月至2017年12月我院收治的100例AML患者,分别于治疗前,治疗后1、3、6、12个月采用RQ-PCR技术检测WT1基因表达水平,采用FCM分析患者微小残留病灶(MRD)水平。随访1年后,根据预后情况分为缓解组54例和复发组46例,探讨两组间WT1基因表达水平和MRD水平变化。结果:治疗后1、3、6、12个月,复发组的FCM-MRD阳性率高于缓解组(P<0.05或P<0.01)。治疗后3、6、12个月,复发组WT1基因的表达量高于缓解组(P<0.01)。WT1基因与FCMMRD联合预测AML早期复发的敏感性、特异性、阳性预测值、阴性预测值、有效性均高于单独WT1基因和单独FCMMRD(P<0.05)。结论:定期监测AML患者WT1基因表达水平和MRD水平,有助于预测疾病复发风险。Objective:To investigate the clinical value of WT1 gene combined with FCM-MRD in predicting the early recurrence of acute myeloid leukemia(AML).Methods:100 patients with AML admitted to our hospital from December 2014 to December 2017 were selected.The expression of WT1 gene was detected by RQ-PCR before treatment,1 month,3 months,6 months and 12 months after treatment,and the level of minimal residual disease(MRD)was analyzed by FCM.One year after follow-up,the patients were divided into remission group(54 cases)and relapse group(46 cases)according to the prognosis.The changes of WT1 gene expression level and MRD level between the two groups were explored.Results:At 1,3,6 and 12 months after treatment,the positive rate of FCM-MRD in the relapse group was higher than that in the remission group(P<0.05 or P<0.01).At 3,6 and 12 months after treatment,the expression of WT1 gene in the relapse group was higher than that in the remission group(P<0.01).The sensitivity,specificity,positive predictive value,negative predictive value and effectiveness of WT1 gene combined with FCM-MRD in predicting early recurrence of acute myeloid leukemia were higher than those of WT1 gene alone and FCM-MRD alone(P<0.05).Conclusion:Regular monitoring of WT1 gene expression levels and MRD levels in AML patients can help predict the risk of disease recurrence in advance.

关 键 词：WT1基因 FCM-MRD检测 急性髓系白血病 复发 

分 类 号：R733.71[医药卫生—肿瘤]