wt1定量联合FCM在急性髓细胞白血病MRD监测中的临床应用

发布时间：2018-03-23 21:14

本文选题：Wilms瘤基因　切入点：急性髓细胞白血病　出处：《安徽医科大学学报》2017年03期

【摘要】：目的探讨在急性髓细胞白血病(AML)中Wilms瘤基因1(wt1)mRNA定量联合多参数流式细胞术(FCM)分析监测微小残留病灶的临床应用。方法采用实时荧光定量聚合酶链反应技术(qRT-PCR)检测35例AML患者的wt1表达水平;将患者根据不同亚型分组检测;并且对9例缓解和4例复发患者进行随访,检测wt1表达水平。采用FCM分析AML中微小残留病灶(MRD)水平。结果与对照组比较,AML病例组wt1表达水平明显增高,差异有统计学意义(P0.05)。在初诊的各种AML亚型中,M2亚型wt1表达水平最高,M6亚型wt1表达水平最低。9例随访患者提示在达到完全缓解时wt1表达水平下降,而4例随访复发患者在复发时再次升高。FCM检测MRD在不同阶段异常髓系细胞比例明显不同。联合qRT-PCR和FCM技术对MRD检测的敏感性和特异性大大提高,两者具有一致性;利用ROC曲线对复发病例进行分析得到的监测阈值为3.33%。结论在急性髓细胞白血病中wt1 mRNA定量联合多参数流式细胞术分析可用于监测MRD、评估治疗效果、预后及预测疾病复发风险。
[Abstract]:Objective to investigate the clinical application of quantitative analysis of Wilms tumor gene 1(wt1)mRNA and multiparameter flow cytometry (FCM) in detection of minimal residual lesions in acute myeloid leukemia (AMLL). Methods Real-time fluorescence quantitative polymerase chain reaction technique was used to detect minimal residual lesions. The expression of wt1 in 35 patients with AML; The patients were grouped according to different subtypes, and 9 patients with remission and 4 patients with recurrence were followed up. The expression of wt1 in AML was detected by FCM. Results compared with the control group, the expression of wt1 in AML patients was significantly higher than that in the control group. The highest wt1 expression level of M _ 2 subtype and the lowest wt1 expression level of M _ 6 subtype in all the newly diagnosed AML subtypes suggested that the wt1 expression level decreased at the time of complete remission. However, the proportion of abnormal myeloid cells in 4 patients with recurrent MRD was significantly different at different stages. The sensitivity and specificity of combined qRT-PCR and FCM in detecting MRD were significantly higher than those in the control group. The sensitivity and specificity of the combination of qRT-PCR and FCM in the detection of MRD were consistent with each other. Conclusion in acute myeloid leukemia, the quantitative analysis of wt1 mRNA combined with multiparameter flow cytometry can be used to monitor MRDs, evaluate the therapeutic effect, prognosis and predict the risk of disease recurrence.
【作者单位】：安徽医科大学附属省立医院中心实验室;
【基金】：国家自然科学基金(编号:81171605)
【分类号】：R733.71

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