摘要
目的将WT1基因作为同期对照基因,探讨尾型同源盒转录因子-2(CDX2)在儿童急性白血病(AL)中的表达特点、临床意义及潜力。方法应用RT-PCR技术同期检测儿童白血病患者骨髓(BM)、外周血(PM)单个核细胞(MNC)CDX2基因、WT1基因的表达。2009年1月至2011年1月西京医院收治儿童急性白血病患者共57例,未缓解组39例,其中初发35例(ALL25例,AML10例),复发4例;AL缓解组18例;25例健康体检者对照。结果未缓解组82.1%(32/39例)AL患儿CDX2基因不同程度高表达(0.6187±0.2170),其中ALL组和AML组阳性率(89.3%vs.63.6%)、表达水平(0.6181±0.2342vs.0.6230±0.2441)无统计学意义(P>0.05)。缓解组、对照组CDX2基因表达均阴性。9例初发白血病同期BM、PB中MNCsCDX2基因表达水平分别为(0.4083±0.2279)、(0.4124±0.1749),差异无统计学意义(P>0.05)。ALCDX2基因、WT1基因表达的比较:未缓解组阳性率(48.7%vs.82.1%)差异有统计学意义(P<0.05),其中ALL组(46.4%vs.89.3%)差异有统计学意义(P<0.05),AML组(54.5%vs.63.6%)差异无统计学意义(P>0.05)。CDX2基因表达阳性、阴性AL患儿WT1基因阳性率分别46.8%(15/32)和57.1%(4/7),统计分析CDX2基因与WT1基因在儿童AL中的表达无明显相关性(P>0.05)。初发儿童AL中,CDX2基因表达阳性、阴性者CR率比较两组差异无统计学意义(P>0.05)。CDX2基因、WT1基因表达双阳性组与双阴性组、双阳性组与单阳性组、单阳性组与双阴性组比较差异均无统计学意义。随访11例AL患儿8~14个月,初诊时CDX2表达阳性的9例患儿,5例于治疗第13~19d时转为阴性,余4例于诱导缓解治疗后转为阴性至今。而初诊时CDX2基因表达阴性的患儿,在骨髓CR时仍为阴性,此后持续阴性。结论与WT1基因比较,CDX2基因或为儿童AL更具潜力的泛白血病基因标志,能够一定程度反映疾病的状态和白血病负荷,于MRD监测有一定意义。
Objective To study the expression of caudal-related homeodomain transcription 2 (CDX2) gene in Children with acute leukemia (AL) and its clinical implications , and compare with those of Wilms' tumor 1 (WT1) gene. Methods Both of the genes were detected by semi-quantitative reverse transcriptase polymerase chain reaction (RT-PCR) in bone marrow(BM) and peripheral blood(PB) samples of 57 cases of children with acute leukemia---39 cases of non-remission acute leukemia (AL) consisting of 35 cases of the newly diagnosed (25 cases of ALL, 10 cases of AML) and 4 cases of the relapsed, 18 cases of the remission. In addition , 25 cases of healthy people were enrolled as control. Results The overexpression(0.6187±0.2170)of CDX2 was found in 82.1% (32/39) AL, with the positive rate being 89.3% (25/28) in ALL and 63.6% (7/11 ) in AML, which showed no statistical difference (P 〉 0.05) and so was the expression level (0.6181 ± 0.2342 VS 0.6230 ± 0.2441) (P 〉 0.05). In addition, CDX2 was not detectable in both the remission group and the control. Detecting samples of BM and PB from the same period of 9 newly diagnosed AL patients by semi-quantitative RT-PCR, the average CDX2 expression level was (0.4083 ± 0.2279) and (0.4124 ± 0.1749) , which was of no statistical difference (P〉 0.05). In compariing CDX2 with WT1 in children with AL, positive rates in non-remission group (48.7% VS 82.1% ) had statistical difference (P 〈 0.05), and those in ALL group (46.4% VS 89.3% ) also showed statistically significant difference (P 〈 0.05), while those in AML group(54.5% VS 63.6% ) were of no statistical difference (P 〉 0.05).In CDX2 positively and negatively expressed patients, positive rates of WT1 were respectively 46.8% (15/32)and 57.1% (4/7), which suggested no statistical correlation between the ex- pression of CDX2 and that of WT1 in AL children. In the newly diagnosed AL children, rates of complete remission (
出处
《中国实用儿科杂志》
CSCD
北大核心
2013年第3期195-199,共5页
Chinese Journal of Practical Pediatrics
关键词
尾型同源盒转录因子-2
WT1基因
白血病
微小残留病
儿童
Caudal-related homeodomain transcription 2
Wilms' tumor 1
leukemia
minimal residual disease
children