基于WT-1基因表达评估急性白血病患者化疗疗效

doi:10.3969/j.issn.1673-8640.2026.08.009

摘要/Abstract

摘要：

目的探讨急性白血病患者化疗前后WT-1基因表达的动态变化及其对疗效评估的意义。方法选取2019年6月—2024年6月保定市第一中心医院急性白血病患者350例，按照治疗方式分为实验组（175例接受标准化疗方案）和对照组（175例治疗未化疗或仅接受姑息性治疗）。采集所有研究对象入组前和入组后特定时间点骨髓样本，采用实时荧光定量聚合酶链反应检测WT-1基因相对表达量；检测血常规指标（白细胞计数、血红蛋白、血小板计数）、骨髓原始细胞比例；比较2个组各项指标差异。参照国际通用疗效标准评估临床疗效。结果入组时2个组WT-1基因相对表达量差异无统计学意义（P=0.132）；入组后3个月、6个月和12个月，实验组WT-1基因相对表达量均低于对照组（P<0.001）。实验组中，完全缓解（CR）患者化疗后WT-1基因相对表达量低于部分缓解（PR）和未缓解（NR）患者（P<0.05）。化疗后CR患者血常规指标有所改善，PR和NR患者改善不明显。实验组无病生存期（DFS）长于对照组（P<0.05），血清WT-1基因低表达组生存率高于高表达组（χ²=69.544，P<0.001）。结论急性白血病患者治疗前后WT-1基因相对表达量可作为评估疗效和预后的重要指标，接受标准方案化疗的患者WT-1相对表达量降低与DFS延长有关。

关键词: WT-1基因, 急性白血病, 标准化疗, 无病生存期

Abstract:

Objective To investigate the dynamic changes of WT-1 gene expression in patients with acute leukemia before and after chemotherapy and its role for evaluating therapeutic efficacy. Methods From June 2019 to June 2024，350 patients with acute leukemia at Baoding First Central Hospital were enrolled. They were classified into experimental group（175 cases，standard chemotherapy） and control group（175 cases，no chemotherapy or only palliative treatment）. Bone marrow samples were collected at specific time points before and after enrollment. The relative expression level of WT-1 gene was determined by real-time fluorescence quantitative polymerase chain reaction. Blood routine indicators （white blood cell count，hemoglobin，platelet count） and the proportion of bone marrow blasts were determined. The differences in various indicators between the 2 groups were compared. The clinical efficacy was evaluated according to the international standard. Results There was no statistical significance in WT-1 gene relative expression levels between the 2 groups before enrollment（P=0.132）. For 3，6 and 12 months after enrollment，the WT-1 gene relative expression level in experimental group was lower than that in control group（P<0.001）. In experimental group，the WT-1 gene relative expression level of patients with complete remission（CR） after chemotherapy was lower than those of patients with partial remission（PR） and non-remission（NR）（P<0.05）. The blood routine indicators of patients with CR after chemotherapy improved，while those of patients with PR and NR did not show significant improvement. The disease-free survival（DFS） of experimental group was longer than that of control group（P<0.05），and the survival rate of patients with low serum WT-1 gene relative expression was higher than that of patients with high expression（χ²=69.544，P<0.001）. Conclusions The relative expression level of WT-1 gene in patients with acute leukemia before and after treatment can be used as an indicator for evaluating therapeutic efficacy and prognosis. The decrease in WT-1 gene relative expression level in patients receiving standard chemotherapy is associated with prolonged DFS.

Key words: WT-1 gene, Acute leukemia, Standard chemotherapy, Disease-free survival

中图分类号:

R446.7

谢晓云, 祖志超, 梁洪彬, 苏恒熙, 常文龙. 基于WT-1基因表达评估急性白血病患者化疗疗效[J]. 检验医学, 2026, 41(8): 774-778.

XIE Xiaoyun, ZU Zhichao, LIANG Hongbin, SU Hengxi, CHANG Wenlong. Evaluation of chemotherapy efficacy in acute leukemia patients based on WT-1 gene expression levels[J]. Laboratory Medicine, 2026, 41(8): 774-778.

图/表 4

参考文献 21

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组别	例数	年龄/岁	性别		白血病类型
组别	例数	年龄/岁	男/例	女/例	AML/例	ALL/例
实验组	175	38.5±12.6	92	83	105	70
对照组	175	39.2±13.1	88	87	102	73
统计值		0.510	0.183		0.106
P值		0.654	0.782		0.816

组别	例数	年龄/岁	性别		白血病类型
组别	例数	年龄/岁	男/例	女/例	AML/例	ALL/例
实验组	175	38.5±12.6	92	83	105	70
对照组	175	39.2±13.1	88	87	102	73
统计值		0.510	0.183		0.106
P值		0.654	0.782		0.816

组别	例数	入组时	入组3个月	入组6个月	入组12个月
实验组	175	1.25±0.32	0.85±0.21^*	0.52±0.15^*	0.35±0.10^*
对照组	175	1.20±0.30	1.05±0.25^*	0.78±0.20^*	0.58±0.12^*
t值		1.508	8.103	13.758	19.478
P值		0.132	<0.001	<0.001	<0.001

组别	例数	入组时	入组3个月	入组6个月	入组12个月
实验组	175	1.25±0.32	0.85±0.21^*	0.52±0.15^*	0.35±0.10^*
对照组	175	1.20±0.30	1.05±0.25^*	0.78±0.20^*	0.58±0.12^*
t值		1.508	8.103	13.758	19.478
P值		0.132	<0.001	<0.001	<0.001

疗效	例数	白细胞计数/（×10⁹L^-1）		血红蛋白/（g·L^-1）		血小板计数/（×10⁹L^-1）
疗效	例数	入组时	入组12个月	入组时	入组12个月	入组时	入组12个月
CR	81	25.61±10.25	6.53±2.15^△	75.34±12.64	105.10±15.23^△	50.09±10.56	150.74±20.22^△
PR	79	23.80±9.54	15.20±5.60^*△	72.30±10.04	85.15±12.54^*△	48.64±8.82	80.92±10.28^*△
NR	15	24.56±10.51	20.35±6.87^*#	70.24±11.16	72.05±10.37^*#	45.39±9.47	55.59±8.34^*#△
统计值		0.663	105.235	2.102	61.982	1.598	503.500
P值		0.517	<0.001	0.125	<0.001	0.205	<0.001