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目的探讨急性白血病 (AL)患者骨髓细胞WT1基因表达水平。方法建立实时定量RT PCR方法 ,检测了 10 8例AL患者和 2 3例非白血病患者骨髓细胞WT1基因及内参照 β 胆色原脱氢酶 (GAPDH)基因的表达水平。结果初诊与复发AL患者骨髓细胞WT1基因中位表达水平经GAPDH校正后分别为 75 .10和 89.5 6 ,明显高于完全缓解组和对照组 (分别为 2 .0 7和 1.5 1) ,对照组与完全缓解组之间及初诊与复发组之间无统计学差异 ;70例初诊AL中急性淋巴细胞白血病、M1、M2 、M3 亚型WT1基因表达水平明显高于M5,即粒系表达明显高于单核系 ,且WT1基因表达水平与白细胞计数、骨髓原始细胞比例、mdr1基因表达无相关性 ,但与染色体核型有关。对其中 2例患者动态检测WT1基因表达可提示白血病复发情况。结论WT1基因在AL患者骨髓细胞高表达 ,可作为白血病疗效评价及监测残留病灶的指标。
Objective To investigate the expression of WT1 gene in bone marrow cells of patients with acute leukemia (AL). Methods The real-time quantitative RT-PCR method was established to detect the expression of WT1 gene and beta-gland precursor protein (GAPDH) gene in bone marrow cells of 108 AL patients and 23 non-leukemia patients. Results The median expression of WT1 gene in newly diagnosed and relapsed AL patients was 75.10 and 89.56, respectively, after GAPDH correction, which was significantly higher than that of the complete remission and control groups (2.07 and 1.51 respectively) and the control group And complete remission group and no difference between newly diagnosed group and recurrent group. The expression of WT1 gene in acute lymphoblastic leukemia, M1, M2 and M3 subtypes in 70 newly diagnosed AL patients was significantly higher than that in M5, In monocytes, the expression level of WT1 was not related to leukocyte count, the ratio of bone marrow blast cells and the expression of mdr1 gene, but it was related to the karyotype. Two cases of dynamic detection of WT1 gene expression may prompt the recurrence of leukemia. Conclusion WT1 gene is highly expressed in bone marrow cells of patients with AL, which can be used as an index to evaluate the efficacy of leukemia and monitor the residual lesions.