定量检测WT-1基因在急性白血病病人中的表达及临床意义

    Quantitative detection of the WT-1 gene expression in acute leukemia patients and its clinical significance

    • 摘要:
      目的研究Wilms基因(WT-1)在急性髓系白血病(AML)病人骨髓细胞中的表达,并分析其表达与临床疗效的关系。
      方法收集AML病人66例,其中急性早幼粒细胞白血病(APL)组8例,急性非淋巴细胞白血病(ANLL,除APL)组58例。对照组20名为健康体检者。采用实时定量PCR法检测骨髓细胞中WT-1表达,并以WT-1的中位表达水平作为界值,将初诊AML病人(APL除外)分为WT-1高表达组和低表达组,并分析其表达与病人性别、年龄、骨髓原幼细胞比例、外周血白细胞数、血红蛋白、血小板数、乳酸脱氢酶(LDH)、C反应蛋白(CRP)、降钙素原(PCT)、完全缓解(CR)率及复发率的关系,以揭示WT-1基因表达水平与AML预后的关系。
      结果病例组与对照组相比WT-1表达率差异有统计学意义(χ2=29.34,P < 0.01)。各组WT-1表达水平相比差异有统计学意义(F=7.206,P < 0.05),与对照组相比,APL病人和ANLL中M1的病人的WT-1表达水平均较高(P < 0.05)。ANLL病人各亚型间相比差异有统计学意义(F=4.981,P < 0.05),与M1组病人相比,M2组和M3组病人的WT-1表达水平相对较低(P < 0.05);与WT-1低表达组相比,WT-1高表达组中骨髓原幼细胞比例、外周血白细胞数显著升高(P < 0.05);而性别、年龄、血红蛋白、血小板数、LDH、CRP、PCT差异无统计学意义(P>0.05),2组病人预后水平差异无统计学意义(P>0.05);AML病人WT-1高表达组CR率低于低表达组(P < 0.05)。
      结论WT-1在AML病人骨髓细胞中表达水平可作为临床评估疾病的预后、疗效的指标。

       

      Abstract:
      ObjectiveTo study the expression of Wilms gene (WT-1) in bone marrow cells of patients with acute myeloid leukemia (AML), and analyze the relationship between the expression level of WT-1 and clinical efficacy.
      MethodsThe clinical data of 66 AML patients, which included 8 patients with acute promyelocytic leukemia (APL) and 58 patients with acute non-lymphocytic leukemia (ANLL, except APL), were collected.Twenty healthy people were set as the control group.The expression levels of WT-1 in bone marrow cells of AML patients were detected using real-time quantitative PCR.The median level of WT-1 was set as the clinic value, the 58 newly diagnosed as ANLL patients were divided into the high-expression WT-1 group and low-expression WT-1 group.The relationship between the expression level of WT-1 and sex, age, ratio of progenitor cells, count of peripheral white blood cells, hemoglobin, platelets, lactate dehydrogenase (LDH), C-reactive protein (CRP), calcitonin (PCT), complete remission rate (CR) and relapse rate were analyzed, and the relationship between WT-1 gene expression level and prognosis of AML patients was revealed.
      ResultsThe difference of the expression rate of WT-1 between cases group and control group was statistically significant (P < 0.01), and the difference of the expression level of WT-1 among each group was statistically significant (P < 0.05).Compared with the control group, the expression levels of WT-1 in APL patients and M1 group were higher (P < 0.05).The difference of the expression level of WT-1 among ANLL patient subtypes was statistically significant (P < 0.05).Compared with the M1 group, the expression levels of WT-1 in M2 and M3 group were relatively low (P < 0.05).Compared with the low WT-1 expression group, the proportion of bone marrow progenitor cells and number of peripheral blood white blood cells in high WT-1 expression group significantly increased (P < 0.05).There was no statistical significance in gender, age, hemoglobin, platelet count, LDH, CRP, and PCT between low and high WT-1 expression groups (P>0.05), and there was no statistical significance in prognosis between two groups (P>0.05).The CR rate of AML patients in high WT-1 expression group was lower than that in low WT-1 expression group (P < 0.05).
      ConclusionsThe expression level of WT-1 in bone marrow cells of patients with AML can be used as an index to evaluate the prognosis and curative effect of the disease.

       

    /

    返回文章
    返回