肾母细胞瘤-1 mRNA表达水平及多参数流式细胞术—微小残留病灶与急性淋巴细胞白血病患儿预后的关系  

Relationship between WT-1 mRNA expression level and multiparameter flow cytometry-minimal residual disease (FCM-MRD) and prognosis in children with acute lymphoblastic leukemia

作　　者：李妍[1] 史利欢 刘俊闪 谢昕 刘云婧 Li Yan;Shi Lihuan;Liu Junshan;Xie Xin;Liu Yunjing(Hematology Research Laboratory(Henan Provincial Key Laboratory of Pediatric Hematology),Children's Hospital Affiliated to Zhengzhou University,Zhengzhou Children's Hospital of Henan Children's Hospital,Zhengzhou,Henan 450018,China)

机构地区：[1]郑州大学附属儿童医院、河南省儿童医院郑州儿童医院、血液病研究室(河南省小儿血液医学重点实验室),河南郑州450018

出　　处：《齐齐哈尔医学院学报》2025年第7期634-639,共6页Journal of Qiqihar Medical University

摘　　要：目的 探讨肾母细胞瘤-1(WT-1)mRNA表达水平及多参数流式细胞术-微小残留病灶(FCM-MRD)与急性淋巴细胞白血病(ALL)患儿预后的关系。方法 选择2022年4月—2023年4月本院收治的98例ALL患儿作为研究组,根据预后情况将患儿分为预后良好组(60例)和预后不良组(38例);另选取同期非恶性血液病患儿98例作为对照组。采用qRT-PCR检测WT-1 mRNA表达水平,流式细胞仪检测FCM-MRD;ALL患儿预后的影响因素采用COX回归分析;绘制ROC曲线分析WT-1 mRNA表达水平及FCM-MRD对ALL患儿预后不良的预测价值。结果 研究组WT-1 mRNA表达水平及FCM-MRD阳性率明显高于对照组(P<0.05)。ALL患儿中WT-1 mRNA及FCM-MRD与临床特征(危险度分层、白细胞计数、原始细胞比例和乳酸脱氢酶)有关(P<0.05)。预后不良组WT-1 mRNA表达水平及FCM-MRD阳性率高于预后良好组(P<0.05)。多因素COX回归分析结果显示,WT-1 mRNA、FCM-MRD、临床特征(危险度分层、白细胞计数、原始细胞比例和乳酸脱氢酶)均是影响ALL患儿预后不良的危险因素(P<0.05)。根据ROC曲线得知,WT-1 mRNA预测ALL患儿预后不良的AUC为0.823,FCM-MRD预测ALL患儿预后不良的AUC为0.843,二者联合预测ALL患儿预后不良的AUC为0.930,二者联合优于各自单独预测(Z_(联合vs WT-1 mRNA)=2.683、Z_(联合vs FCM-MRD)=2.712,P均<0.05)。结论 WT-1 mRNA表达水平及多参数FCM-MRD在ALL患儿中均增加,二者均与患儿预后有关,联合检测可有效提高ALL患儿预后的预测价值。Objective To explore the relationship between the expression level of Wilms'tumor-1(WT-1)mRNA and multiparameter flow cytometry-minimal residual disease(FCM-MRD)with the prognosis of children with acute lymphoblastic leukemia(ALL).Methods Ninety-eight children with ALL admitted to our hospital from April 2022 to April 2023 were selected as the study group,which was divided into a good prognosis group(60 cases)and a poor prognosis group(38 cases)based on prognosis.Additionally,98 children with non-malignant hematological diseases were chosen as the control group.Quantitative real-time PCR(qRT-PCR)was used to detect WT-1 mRNA expression levels,and flow cytometry was used to detect FCM-MRD.The impact factors of ALL prognosis were analyzed using COX regression analysis,and the predictive value of WT-1 mRNA expression levels and FCM-MRD for poor prognosis in ALL children was analyzed using ROC curves.Results The WT-1 mRNA expression levels and FCM-MRD positivity rates in the study group were significantly higher than those in the control group(P<0.05).WT-1 mRNA and FCM-MRD were associated with clinical characteristics(risk stratification,white blood cell count,proportion of blasts,and lactate dehydrogenase levels)in ALL patients(P<0.05).The poor prognosis group had significantly higher WT-1 mRNA expression levels and FCM-MRD positivity rates than the good prognosis group(P<0.05).Multivariable COX regression analysis indicated that WT-1 mRNA,FCM-MRD,and clinical characteristics(risk stratification,white blood cell count,proportion of blasts,and lactate dehydrogenase levels)were risk factors for poor prognosis in ALL patients(P<0.05).According to the ROC curves,the AUC for WT-1 mRNA in predicting poor prognosis in ALL patients was 0.823,for FCM-MRD it was 0.843,and the combined AUC for both was 0.930,which was superior to either alone(Z combined vs.WT-1 mRNA=2.683,Z combined vs.FCM-MRD=2.712,P<0.05).Conclusions The expression levels of WT-1 mRNA and multiparameter FCM-MRD are both increased in ALL children and are assoc

关 键 词：肾母细胞瘤-1 多参数流式细胞术-微小残留病灶 急性淋巴细胞白血病 预后 预测 

分 类 号：R733.71[医药卫生—肿瘤]