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目的 比较外周血 (PB)和骨髓 (BM)标本中WT1基因的表达在儿童白血病微小残留病(MRD)检测中的意义。方法 采用筑巢式逆转录 聚合酶链反应 (RT PCR) ,同步动态观察了 34例急性白血病 (AL)患儿的PB及BM单个核细胞WT1基因表达的相对水平。结果 (1) 34例AL患儿的BM中WT1阳性表达为 2 7例 ,表达水平 0 784± 0 311;PB中为 2 6例 ,表达水平为 0 734± 0 2 95 ,两者的阳性率及表达水平差异无显著性。 (2 )完全缓解后PB与BM中WT1表达水平明显下降。PB中WT1表达阳性的 5例均复发 ,转阴的 13例中有 3例复发 ,P =0 0 0 6 5 ,差异有显著性 ;而BM标本中WT1表达阳性与转阴者之间差异无显著性。结论 动态观察儿童急性白血病WT1基因的改变 ,可监测MRD ,预测复发。而PB在MRD监测中比BM特异性更强 ,临床应用更方便。
Objective To compare the expression of WT1 gene in peripheral blood (PB) and bone marrow (BM) specimens in the detection of minimal residual disease (MRD) in childhood leukemia. Methods The relative level of WT1 gene expression in PB and BM mononuclear cells of 34 children with acute leukemia (AL) was dynamically detected by nested reverse transcriptase polymerase chain reaction (RT PCR). Results (1) The WT1 positive expression in BM of 34 children with AL was 27 cases, the expression level was 0 784 ± 0 311; in 26 cases PB, the expression level was 0 734 ± 0 2 95, the positive rate of both There was no significant difference in expression level. (2) After complete remission, the expression of WT1 in PB and BM decreased significantly. In PB, the positive expression of WT1 all recurred in 5 of 13 cases, and the recurrence in 3 of 13 cases with recurrence was significant (P = 0.00605). However, there was no significant difference between WT and WT Significance. Conclusion The dynamic observation of the changes of WT1 gene in children with acute leukemia can monitor the MRD and predict the recurrence. PB is more specific than BM in MRD monitoring and is more convenient for clinical application.