| WT1基因在急性髓系白血病M2型患者中的表达及对其预后的影响 |
| 投稿时间：2024-08-20 修订日期：2024-09-09 点此下载全文 |
| 引用本文：齐松青,刘洋,朱洁,张振南,王新有.WT1基因在急性髓系白血病M2型患者中的表达及对其预后的影响[J].医学研究杂志,2025,54(1):61-66, 72 |
| DOI：
10.11969/j.issn.1673-548X.2025.01.012 |
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| 基金项目:新疆维吾尔自治区自然科学基金资助项目(面上项目)(2024D01C181、2020D01C237)；新疆医科大学医学科学研究所开发课题资助项目(YXYJLHYI20240304) |
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| 中文摘要:目的 探讨急性髓系白血病M2型(AML-M2)患者骨髓中WT1基因的表达水平及对AML-M2患者疗效及预后的影响。方法 qRT-PCR方法检测126例AML-M2患者和30例对照样本骨髓中WT1基因和AML1-ETO基因表达量；Sanger基因测序法检测NPM1、FLT3-ITD/TKD、C-Kit8/17、DNMT3A及CEBPa基因突变情况； 结果 WT1基因在AML-M2患者中的表达水平明显高于对照组(0.0024 vs 0.080, P<0.001)。WT1基因表达水平与年龄呈正相关,差异有统计学意义(r=0.314,P=0.011),WT1基因表达水平与骨髓原始细胞数量比例呈正相关,差异有统计学意义(r=0.534,P=0.010)。比较染色体核型分析发现正常核型组、核型异常组的WT1基因表达水平比较,差异有统计学意义(P=0.040)；比较AML1-ETO阳性组和AML1-ETO阴性组分析发现两组的WT1基因表达水平差异有统计学意义(P=0.032)；初治AML1-ETO阳性的AML-M2患者骨髓中的WT1基因与AML1-ETO 基因表达水平呈正相关(r=0.524,P=0.037),并同时有效追踪20例初治AML1-ETO阳性患者的AML1-ETO基因及WT1基因表达量,均呈正相关(P＜0.05)；WT1基因高表达组与WT1基因低表达组完全缓解(complete remission,CR)率比较,差异无统计学意义(66.7％ vs 60.4％, P＞0.05)；单因素分析及多因素COX分析均提示WT1高表达组有较高的总生存(overall survival,OS)率(P＜0.05)； 结论 骨髓中WT1基因表达水平可能可以作为监测微小残留病(minimal residual disease,MRD)的一项分子指标,对于AML-M2患者预后评估具有重要的临床意义。 |
| 中文关键词:WT1基因 急性粒细胞部分分化型白血病 AML1-ETO基因 |
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| Expression of WT1 Gene in Patients with Acute Myeloid Leukemia M2 and Its Impact on Prognosis. |
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| Abstract:Objective To investigate the expression level of WT1 gene in the bone marrow of patients with AML-M2 and its impact on the therapeutic effect and prognosis. Methods qRT-PCR was used to detect WT1 gene and AML1-ETO gene expression in bone marrow of 126 patients with AML-M2 and 30 control samples. The mutations of NPM1, FLT3-ITD/TKD, C-Kit8/17, DNMT3A and CEBPa were detected by Sanger gene sequencing method. Results The expression level of WT1 gene was significantly higher in patients with AML-M2 than the control group (0.0024 vs 0.080, P<0.001). The level of WT1 gene expression was positively correlated with age (r=0.314, P=0.011) and the proportion of bone marrow original cells (r=0.534, P=0.010), the differences were statistically significant. The expression level of WT1 gene in normal karyotype group and abnormal karyotype group was significantly different (P=0.040). A comparison of AML1-ETO positive group and AML1-ETO negative group showed that the WT1 gene expression levels of the two groups were significantly different (P=0.032). The WT1 gene in the bone marrow of patients, who were AML1-ETO positive, with AML-M2 was positively correlated with the AML1-ETO gene expression level (r=0.524, P=0.037), and the AML1-ETO gene and WT1 gene expression levels were effectively tracked in 20 patients who werel AML1-ETO positive, with all positively correlationship (P<0.05). There was no significant difference in the complete remission (CR) rate between WT1 gene high expression group and WT1 gene low expression group (66.7% vs 60.4%, P>0.05). Both univariate analysis and multivariate COX analysis indicated that WT1 high expression group had higher overall survival (OS) rate (P<0.05). Conclusion The expression level of WT1 gene in bone marrow may be used as a molecular index to monitor minimal residual disease (MRD), which has important clinical significance for prognosis assessment of AML-M2 patients. |
| keywords:WT1 gene Acute myelomonocytic leukemia AML1-ETO gene |
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