WT1基因在骨髓增生异常综合征患者骨髓中的表达及其临床意义  

Expression of Wilms’ Tumor 1 Gene in Bone Marrow of Patients with Myelodysplastic Syndrome and Its Clinical Significance

作　　者：潘丹琪 赵文舒 阴常欣[1] 何涵[1] 林韧[1] 赵珂[1] 叶洁瑜[1] 刘启发[1] 戴敏[1] PAN Dan-Qi;ZHAO Wen-Shu;YIN Chang-Xin;HE Han;LIN Ren;ZHAO Ke;YE Jie-Yu;LIU Qi-Fa;DAI Min(Department of Hematology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Guangdong Province,China)

机构地区：[1]南方医科大学南方医院血液内科,广东广州510515

出　　处：《中国实验血液学杂志》2022年第5期1501-1507,共7页Journal of Experimental Hematology

摘　　要：目的:探究WT1基因在骨髓增生异常综合征(MDS)患者骨髓中的表达水平及其临床意义。方法:回顾性分析2017年1月至2021年4月在南方医科大学南方医院就诊的147例初发MDS患者的临床资料,应用实时荧光定量PCR检测骨髓WT1基因表达,根据其表达水平分为WT1^(+)和WT1^(-)两组,分析两组患者的临床特点和预后。结果:147例MDS患者WT1^(+)率为82.3%。WT1^(+)和WT1^(-)两组患者的骨髓原始细胞比例、异常染色体核型、WHO 2016分型及IPSS-R危险分层差异均有统计学意义(均P<0.05);MDS亚型恶性程度及IPSS-R危险分层越高,WT1表达水平越高。WT1^(+)和WT1^(-)两组患者中位OS、进展为白血病时间差异均无统计学意义(均P>0.05)。在未移植患者中,WT1^(+)患者中位OS较WT1^(-)患者显著缩短(P=0.049)。WT1^(+)移植患者预后明显优于去甲基化治疗患者(P=0.002),且死亡率低(P=0.005)。结论:WT1基因表达水平可用于评估MDS患者病情,与MDS患者预后密切相关。Objective: To investigate the expression level and clinical significance of Wilms ′tumor 1(WT1) in bone marrow of patients with myelodysplastic syndromes(MDS). Methods: The clinical data of 147 MDS patients who accepted real-time quantitative polymerase chain reaction(RT-PCR) to detect the expression level of WT1 in bone marrow before treated in Nanfang Hospital, Southern Medical University from January 2017 to April 2021 were retrospectively analyzed. According to the expression level of WT1, the patients were divided into WT1^(+) group and WT1^(-)group, their clinical characteristics and prognosis were analyzed. Results: The positive rate of WT1 in 147 MDS patients was 82.3%.There were significant differences in bone marrow blast count, aberrant karyotypes, WHO 2016 classification, and IPSS-R stratification between WT1^(+) group and WT1^(-)group(all P<0.05). Furthermore, the higher the malignant degree of MDS subtype and the risk stratification of IPSS-R, the higher expression level of WT1. Compared with WT1^(-)group, there were no differences in overall survival(OS) time and the time of transformation to AML in WT1^(+) group(both P>0.05).In patients who did not accept transplantation, the median OS time of WT1^(+) patients was significantly shorter than that of WT1^(-)patients(P=0.049). Besides, regarding WT1^(+) group, patients who underwent transplantation had longer OS time and lower mortality than those who received hypomethylating agents(P=0.002, P=0.005). Conclusion: WT1 expression level directly reflects the disease progression, and it is also associated with prognosis of MDS patients.

关 键 词：骨髓增生异常综合征 WT1基因 预后 临床意义 

分 类 号：R733.3[医药卫生—肿瘤]