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目的 探讨儿童急性淋巴细胞性白血病 (ALL)WT1基因与肿瘤多药耐药基因 (mdr1)表达的关系 ,为临床判断预后、指导个体化治疗提供依据。方法 采用逆转录聚合酶链反应 (RT PCR)对 33例ALL患儿的同一份标本进行WT1mRNA及mdr1mRNA检测 ,用GQS 96 0图像处理系统软件进行半定量分析。结果 (1)初治组ALL的WT1及mdr1阳性率分别为 6 7%及 15 % ,完全缓解组分别为 2 2 %及 18% ,复发难治组分别为 92 %及 75 % ,初治组和复发难治组WT1阳性率及表达水平与完全缓解组相比 ,P均 <0 0 1,复发难治组中mdr1阳性率及表达水平与初治组和完全缓解组相比 ,P均 <0 0 1,差异均有极显著性 ;(2 )WT1与mdr1表达无明显相关关系 ,但复发难治组WT1与mdr1均阳性者多 ,占 6 7% ,均阴性的为 0 ;与初治组及完全缓解组比较差异有极显著性。结论 ALL患儿WT1基因表达的同时出现肿瘤多药耐药基因表达 ,是白血病难治及复发的重要因素 ,提示预后差。动态监测WT1及mdr1,可预测白血病难治及复发 ,指导个体化治疗 ,有利于清除微小残留白血病细胞
Objective To investigate the relationship between WT1 gene and the expression of multidrug resistance gene (mdr1) in children with acute lymphoblastic leukemia (ALL), and to provide basis for clinical prognosis and individualized treatment. Methods RT-PCR was used to detect the expression of WT1mRNA and mdr1mRNA in the same specimen of 33 children with ALL. Semi-quantitative analysis was performed with GQS 96 0 image processing system software. Results (1) The positive rates of WT1 and mdr1 in ALL group were 67% and 15% respectively, in complete remission group were 22% and 18%, in relapsed and refractory group were 92% and 75% And relapsed and refractory group WT1 positive rate and expression levels compared with the complete remission group, P all <0.01, the recurrence and refractory group mdr1 positive rate and expression levels compared with the initial treatment group and complete remission group, P < There was no significant correlation between the expression of WT1 and mdr1, but the positive rates of WT1 and mdr1 were both 67% and 0% Group and complete remission group compared with the difference was significant. Conclusions The expression of multidrug resistance gene in WT children with ALL is associated with the expression of multidrug resistance gene in children with ALL. It is an important factor in refractory and relapsed leukemia, suggesting a poor prognosis. Dynamic monitoring of WT1 and mdr1 can predict the refractory and relapse of leukemia and guide individualized treatment, which is helpful for the removal of minimal residual leukemia cells