摘要目的 探讨WT1基因在骨髓增生异常综合征(MDS)诊断和预后判断中的意义.方法 采用骨髓涂片提取RNA,通过荧光定量RT-PCR方法,检测45例MDS患者及10例健康人骨髓涂片中WT1表达水平.结果 MDS各亚型WT1基因表达与健康对照组差异有统计学意义,与MDS患者的疾病进展呈正相关;半年内发展为难治性贫血伴原始细胞过多(RAEB)/转化中的难治性贫血伴原始细胞过多(RAEBt)的难治性贫血(RA)患者,其WT1表达明显高于半年内病情稳定的RA患者;在RA期间,WT1表达水平的波动小于1个对数级,从RA发展到RAEB时,WT1表达水平增长1个对数级以上.结论 WT1基因可作为MDS疾病进程的标志物;若WT1表达水平比健康对照平均值高2个对数级,提示可能诊断为RA;若RA患者的WT1表达水平上升大于1个对数级,提示MDS近期内可能发生疾病进展.

abstractsObjective To determine whether pattern of WT1 gene expression is a useful marker for establishing prognosis and tracking disease progression in patients with myelodysplastic syndromes (MDS). Methods RNA were extracted from bone marrow smears of 45 patients with MDS, the WT1 expression were tested by FQ-RT-PCR. Results The degree of WT1 expression was increased during disease progression of MDS. The WT1 expression level was increased more a logarithm grade when a RA patient developed into RAEB, the fluctuation of WT1 expression level was decreased a logarithm grade during RA. Conclusion WT1 gene is a useful marker for assessment in MDS patients. It pointed out may diagnosis RA if the WT1 expression level higher two logarithm grade than the mean of normal control for patients which didn't diagnose by morphology. It may suggest disease progress of MDS if the WT1 expression level increased more a logarithm grade recently. Further confirmation was needed because the case was limited.