【摘要】 目的:通过检测WT1基因在成人急性髓系白血病(非APL)中的表达,探讨其在中、高危急性髓系白血病治疗反应和预后的临床应用价值。方法:选取急性髓系白血病患者63例,其中不包含急性早幼粒细胞白血病患者;应用SYBR Green I定量RT-PCR方法检测63例初治急性髓系白血病患者中WT1基因的表达。结果:WT1基因在急性髓系白血病中高表达,在低危组中的表达明显低于中危组和高危组(P <0.05)。WT1基因在中危组与高危组中的表达无明显统计学差异;中、高危组病人经1疗程正规治疗后,缓解组的WT1基因表达量与未缓解组相比明显下降(P <0.05)。在中、高危组病人中,首次治疗未缓解的病人,给予再次诱导治疗达到缓解病人的WT1基因表达量明显低于未缓解组(P <0.05)。在中高危组病人中,WT1低表达的患者治疗后2年总体生存时间(OS)较未缓解病人明显延长(P <0. 05)。结论:检测WT1基因的表达可有助于急性髓系白血病患者的低、中、高危分群,也有助于评价中、高危急性髓系白血病的治疗及预后情况。更多还原

【Abstract】 Objective: To investigate the exprassion of WT1 gene in patients with adult acute myeloid leukemia(AML) and its clinical significance. Methods: Sixty-three newly diagnosed patients with acute myeloid leukemia were selected. Quantitative RT-PCR was used to detect the expression of WT1 gene in the 63 AML patients and 20 nonAML controls. Results: WT1 gene was highly expressed in AML patents and its expression in the low-risk group was significantly lower than that in middle-risk group and high-risk group(P <0.05), and no significant difference of WT1 gene expression between middle-risk and high-risk group was observed. In the patients of middle-risk and high-risk patients, the expression of WT1 gene in the remission group was significantly lower than that in the patients of nonremission after treatment(P <0.05). The non-remission patients after first treatment in middle-risk and high-risk group were treated with second induction therapy. After second induction therapy, the WT1 expression in remission patients was significantly decreased(P <0.05) in comparison with that in patients still in non-remission. There was a negative correlation between WT1 expression and the 2-year overall survival rate in the newly diagnosed middle and high-risk AML patients. Conclusion: The detection of WT1 gene expression can help to divide AML patients into low-/middle-/high-risk groups and to evaluate therapeutic response and clinical prognosis in middle and high-risk AML patients.更多还原