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目的 探讨WT1基因与白血病发病的关系和临床意义。方法 采用逆转录 巢式聚合酶链反应 (RT 巢式PCR)方法检测了K5 6 2和HL 6 0两个白血病细胞系、4 9例急性白血病 (AL)患者、33例慢性髓系白血病 (CML)患者和 2 5例正常对照的WT1基因表达。结果 K5 6 2和HL 6 0两个白血病细胞系、2 9例初治或复发AL患者中有 2 1例、2 0例完全缓解 (CR)期AL中有 1例、18例CML急变期中有15例、5例CML加速期中有 1例、10例CML慢性期患者中有 1例表达WT1基因。WT1基因表达见于所有AL亚型 ,其相对水平与急性白血病的CR率有相关性。≥ 1.0的患者CR率低及生存期短。在CML中WT1基因表达表现出明显的阶段性 ,与慢性粒细胞白血病临床阶段及病情进展有关。结论 WT1基因表达与白血病发生有关 ,WT1基因高表达的患者CR率低、无病生存期短 ,可作为判断急性白血病预后和监测微量残留病的一项指标 ,也可作为CML急变的一项诊断指标。
Objective To investigate the relationship between WT1 gene and leukemia and its clinical significance. Methods Reverse transcriptase nested polymerase chain reaction (RT-PCR) was used to detect two leukemia cell lines, K5 6 2 and HL 60, 49 acute leukemia (AL) patients and 33 chronic myeloid leukemia ) Patients and 25 normal controls WT1 gene expression. Results There were 21 cases of K562 and HL60 leukemia cell lines, 29 cases of newly diagnosed or recurrent AL, 20 cases of AL in 20 cases of complete remission (CR), 18 cases of CML One case was found in 15 cases, one case was in 5 cases of CML acceleration and one case was in 10 cases of chronic phase of CML. WT1 gene expression is found in all AL subtypes and its relative level correlates with CR rate in acute leukemia. Patients with a CR of ≥ 1.0 have low CR rates and short survival. WT1 gene expression in CML showed a clear stage, with the clinical stage of chronic myeloid leukemia and progression of the disease. Conclusion The expression of WT1 gene is associated with the development of leukemia. The low CR rate and short disease-free survival time of patients with WT1 gene expression can be used as an index to judge the prognosis of acute leukemia and monitor micro-residual disease. It can also be used as a diagnosis of acute myeloid leukemia index.