上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2013, Vol. 33 ›› Issue (6): 801-.doi: 10.3969/j.issn.1674-8115.2013.06.021

• 论著（临床研究） • 上一篇    下一篇

WT1、PRAME和ERG基因在儿童急性白血病中的表达

刘 青1，蒋 慧1，杨永臣2   

  1. 上海交通大学附属儿童医院 1.血液肿瘤科， 2.分子生物学实验室， 上海 200040
  • 出版日期:2013-06-28 发布日期:2013-06-28
  • 通讯作者: 蒋慧, 电子信箱: jhui2006@yahoo.com。
  • 作者简介:刘青（1987—）， 女， 住院医师， 硕士生; 电子信箱: liuqing.ting@163.com。
  • 基金资助:

    上海市卫生局基金（210255）

Expression characteristics of WT1, PRAME and ERG genes in acute leukemia of children

LIU Qing1, JIANG Hui1, YANG Yong-Chen2   

  1. 1.Department of Hematology and Oncology, 2.Molecular Biology Laboratory, Childrens Hospital, Shanghai Jiaotong University, Shanghai 200040, China
  • Online:2013-06-28 Published:2013-06-28
  • Supported by:

    Shanghai Municipal Health Bureau Foundation, 210255

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摘要：

目的 研究肾母细胞瘤基因（WT1）、黑色素瘤优先表达抗原（PRAME）和ETS相关基因（ERG）在儿童急性白血病（AL）中的表达特点，并分析其在白血病微小残留病灶（MRD）监测中的意义。方法 收集92份AL标本（84例患儿），其中初发标本28份，包括急性淋巴细胞白血病（ALL）标本18份，急性髓系白血病（AML）标本10份；AL完全缓解标本63份，包括ALL标本45份，AML标本18份；AL复发标本1份。采用Real-time PCR法检测AL患者骨髓中WT1、PRAME和ERG mRNA的相对表达量，并以同期住院的10例非恶性血液病患儿为对照。结果 AL初发组患儿的WT1、PRAME和ERG mRNA相对表达量均显著高于缓解组和对照组（P<0.05），但缓解组和对照组比较差异无统计学意义（P>0.05）；AML初发组的PRAME mRNA相对表达量显著高于ALL初发组（P<0.05）。28例初发组WT1、PRAME和ERG mRNA的阳性表达率分别为82.4%、92.9%和64.3%，三者间比较差异有统计学意义（P<0.05）；三种基因联合检测的阳性率为100%。跟踪15例AL初发患者，诱导化疗缓解后三种基因的相对表达量均显著低于诱导化疗前（P<0.05）。1例复发患者初发时三种基因均呈阳性表达，缓解后转为阴性，复发时又变为阳性。结论 与非白血病患者相比，WT1、PRAME和ERG mRNA在AL初发患者的骨髓中高度表达，三种基因联合检测可提高阳性率。AL患者的WT1、PRAME、ERG mRNA表达水平与疾病状态相关，适用于MRD的监测。

关键词: 急性白血病, 儿童, 肾母细胞瘤基因, 黑色素瘤优先表达抗原, ETS相关基因, 微小残留病灶

Abstract:

Objective To investigate the expression characteristics of Wilm's tumor 1 gene (WT1), preferentially expressed antigen of melanoma (PRAME) and ETS related genes (ERG) in acute leukemia of children, and explore the significance in monitoring of minimal residual disease (MRD) of leukemia. Methods Ninety-two samples of acute leukemia (84 children) were collected. Twenty-eight samples were newly diagnosed ones, including 18 samples of acute lymphoblastic leukemia (ALL) and 10 samples of acute myeloid leukemia (AML). Sixty-three samples were complete remission ones, including 45 samples of ALL and 18 samples of AML. The other 1 sample was a relapse one. The expression of WT1, PRAME and ERG mRNA in bone marrow was detected by Real-time PCR. Another 10 cases of non-malignant hematological diseases of the same period were served as controls. Results The relative expression of WT1, PRAME and ERG mRNA in newly diagnosed group was significantly higher than that in complete remission group and control group (P<0.05), while there was no significant difference between complete remission group and control group (P>0.05), and the relative expression of PRAME mRNA in newly diagnosed AML group was significantly higher than that in newly diagnosed ALL group (P<0.05). The positive expression rates of WT1, PRAME and ERG mRNA in newly diagnosed group were 82.4%, 92.9% and 64.3% respectively, and there were significant differences among them (P<0.05). The positive rate of joint detection of 3 genes was 100%. The relative expression of 3 genes after induction chemotherapy was significantly lower than that before induction chemotherapy in 15 newly diagnosed patients (P<0.05). The expression of 3 genes in the patient with relapse was positive at the disease onset, negative after remission, and positive again at relapse. Conclusion Compared with patients without leukemia, WT1, PRAME and ERG mRNA is highly expressed in bone marrow of patients with newly diagnosed acute leukemia, and the joint detection of 3 genes may increase the positive rate. The expression of WT1, PRAME and ERG mRNA is related to the disease status in patients with acute leukemia, and may be a useful tool for monitoring MRD.

Key words: acute leukemia, children, Wilm's tumor 1 gene, preferentially expressed antigen of melanoma, ETS related genes, minimal residual disease