【摘要】 目的:探讨WT1基因联合FCM-MRD预测急性髓系白血病(AML)早期复发的临床价值。方法:选取2014年12月至2017年12月我院收治的100例AML患者,分别于治疗前,治疗后1、3、6、12个月采用RQ-PCR技术检测WT1基因表达水平,采用FCM分析患者微小残留病灶(MRD)水平。随访1年后,根据预后情况分为缓解组54例和复发组46例,探讨两组间WT1基因表达水平和MRD水平变化。结果:治疗后1、3、6、12个月,复发组的FCM-MRD阳性率高于缓解组(P <0.05或P <0.01)。治疗后3、6、12个月,复发组WT1基因的表达量高于缓解组(P <0.01)。WT1基因与FCMMRD联合预测AML早期复发的敏感性、特异性、阳性预测值、阴性预测值、有效性均高于单独WT1基因和单独FCMMRD(P <0.05)。结论:定期监测AML患者WT1基因表达水平和MRD水平,有助于预测疾病复发风险。更多还原

【Abstract】 Objective: To investigate the clinical value of WT1 gene combined with FCM-MRD in predicting the early recurrence of acute myeloid leukemia( AML). Methods: 100 patients with AML admitted to our hospital from December 2014 to December 2017 were selected. The expression of WT1 gene was detected by RQ-PCR before treatment,1 month,3 months,6 months and 12 months after treatment,and the level of minimal residual disease( MRD) was analyzed by FCM. One year after follow-up,the patients were divided into remission group( 54 cases) and relapse group( 46 cases) according to the prognosis. The changes of WT1 gene expression level and MRD level between the two groups were explored. Results: At 1,3,6 and 12 months after treatment,the positive rate of FCM-MRD in the relapse group was higher than that in the remission group( P < 0. 05 or P <0. 01). At 3,6 and 12 months after treatment,the expression of WT1 gene in the relapse group was higher than that in the remission group( P < 0. 01). The sensitivity,specificity,positive predictive value,negative predictive value and effectiveness of WT1 gene combined with FCM-MRD in predicting early recurrence of acute myeloid leukemia were higher than those of WT1 gene alone and FCM-MRD alone( P < 0. 05). Conclusion: Regular monitoring of WT1 gene expression levels and MRD levels in AML patients can help predict the risk of disease recurrence in advance.更多还原