OBJECTIVETo investigate the expression level of WT1 gene in bone marrow of patients with acute myeloid leukemia (AML) and its relationship with prognosis.

METHODSThe copy numbers of WT1 and internal reference gene in bone marrow samples from 75 newly diagnosed AML patients were detected by using real-time quantitative PCR. The gene WT1 expression level was determined by the ratio of the copy numbers of WT1 to reference gene. And the clinical characteristics, the complete remission (CR) rate after induction chemotherapy, 2-year overall survival (OS) rate and event-free survival (EFS) rate were calculated and analysed.

RESULTSThe expression level of WT1 did not significantly correlate with common clinical parameters such as age, sex, molecular abnormality, FAB classification and risk stratification. The CR rate in the high WT1 expression group before treatment was 65.4%, which was lower than that of 93.9% in the low expression group (χ2=8.25, P<0.01). The 2-year overall survival rate and event-free survival rate of the two groups were statistically significantly different (P<0.05), and the OS and EFS rates in high WT1 expression group were lower than those in low expression group. After the induction chamotheropy for about 1, 3 month and 6 months, the 2-year OS rate significantly increased in patients with decrease of WT1 gene expression level by one log or more (P<0.05).

CONCLUSIONThe expression level of WT1 gene in bone marrow may be an effective marker to evaluate therapy efficacy and prognosis for AML patients (non APL).

Bone Marrow ; metabolism ; Disease-Free Survival ; Genes, Wilms Tumor ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; Prognosis ; Real-Time Polymerase Chain Reaction ; Remission Induction ; Survival Rate ; WT1 Proteins ; genetics ; metabolism

Congenital aniridia is a rare ocular malformation that presents with severe hypoplasia of the iris and various ocular manifestations. Most cases of congenital aniridia are known to be related to mutations in the paired box gene-6 (PAX6), which is an essential gene in eye development. Herein, we report a familial case of autosomal dominant congenital aniridia with four affected members in 3 consecutive generations and describe the detailed ophthalmologic findings for one of these members. As expected, mutational analysis revealed a nonsense mutation (p.Ser122*) in the PAX6 gene. Thus, our findings reiterate the importance of PAX6 mutations in congenital aniridia.
Aniridia* ; Codon, Nonsense ; Family Characteristics ; Genes, Essential ; Humans ; Iris ; WAGR Syndrome ; Wilms Tumor

Ovarian cancer is the seventh most common cancer in the world and the fifth most common cause of death from cancer; it is responsible for over half of all deaths related to gynecological cancers. The presence of lymphatic metastasis is an important prognostic factor in ovarian cancer. Nodal metastases to the pelvic and the para-aortic lymph nodes are common, particularly in an advanced of the disease (stages III-IV). The finding of distant nodal metastasis, especially subclavian lymph node metastasis, from ovarian carcinoma is very uncommon. 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) or FDG-PET/computed tomography (CT) provides an improved imaging for detecting metastatic lymph nodes in patients with ovarian cancer. Immunohistochemically, ovarian carcinoma cells are positive for estrogen receptor, progesterone receptor, cancer antigen 125, Wilms' tumor 1 protein, and p53; they are negative for thyroid transcription factor (TTF-1) and caudal-related homeobox 2 (CDX-2). This report describes a Korean woman diagnosed with ovarian cancer with subclavian lymph node metastasis revealed by FDG PET/CT and verified by an immunohistochemical staining. Differentiating between the primary ovarian lesion and the metastatic lesion will allow the initiation of an appropriate treatment and help predict the prognosis.
Cause of Death ; Estrogens ; Female ; Genes, Homeobox ; Humans ; Immunohistochemistry* ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Metastasis* ; Ovarian Neoplasms ; Positron-Emission Tomography and Computed Tomography ; Prognosis ; Receptors, Progesterone ; Thyroid Gland ; Transcription Factors ; Wilms Tumor

Steroid-resistant nephrotic syndrome poses a significant clinical challenge. Its pathogenesis has not been fully elucidated. In recent years, numerous studies have shown that podocyte-specific gene mutations may play important roles in the development of steroid-resistant nephrotic syndrome. Among the identified genes mutated in podocytes include NPHS2, NPHS1, WT1, TRPC6, MDR1, PLCE1, LMX1B, and LAMB2. This review aims to summarize the characteristics of these mutated genes in podocytes. The putative role for these podocyte-specific mutated genes in the pathogenesis, diagnosis, treatment and prognosis of steroid-resistant nephrotic syndrome is also discussed.
ATP Binding Cassette Transporter, Sub-Family B ; ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; Genes, Wilms Tumor ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; LIM-Homeodomain Proteins ; genetics ; Membrane Proteins ; genetics ; Mutation ; Nephrotic Syndrome ; congenital ; genetics ; Podocytes ; metabolism ; TRPC Cation Channels ; genetics ; TRPC6 Cation Channel ; Transcription Factors ; genetics

This study was aimed to investigate the expression level of Wilms' tumor 1( WT1) gene in hematologic neoplasm (leukemia, multiple myeloma and lymphoma) patients and its clinical significance. Real-time quantitative polymerase chain reaction (RQ-PCR) was used to detect the copy number of WT1 gene and reference gene (ALB) in bone marrow cells of 228 patients with hematologic neoplasm in our hospital. The gene expression level was determined by using the ratio of the copy number of WT1 gene and reference gene. The results showed that the WT1 expression level between male and female patients was not statistically significantly different (P > 0.05). All the patients were divided into 3 groups: the group aged under 19, the group aged between 19-50, and the group aged over 50; the WT1 expression level among the three groups were not statistically significantly different (P > 0.05) . The above-mentioned patients were redivided into the groups aged under 45 and over 45, the difference between them was not statistically significant (P > 0.05). The difference of WT1 expression level between newly diagnosed patients and treated patients with hematologic neoplasm was statistically significant (P < 0.01), but no statistically significant difference of WT1 expression was found (P > 0.05) at each stage within 3 years after treatment, however, among them the difference between newly diagnosed leukemia patients and treated leukemia patients was very statistically significant (P < 0.01), while the difference between newly diagnosed and treated non-leukemia patients was not statistically significant (P > 0.05). The expression difference of WT1 between leukemia and non-leukemia patients was very statistically significant (P < 0.01), the difference between the newly diagnosed leukemia and non-leukemia patients also was very statistically significant (P < 0.01). The difference of WT1 expression between treated leukemia and non-leukemia patients was not statistically significant (P > 0.05). It is concluded that the WT1 expression level in leukemia patients can be a reliable marker to evaluate the prognosis of newly diagnosed leukemia and the curative effect for minimal residual disease. No WT1 expression difference has been found before and after treatment among the patients with non-leukemia, such as multiple myeloma and lymphoma, therefore, which should be furtherly explored.
Aged ; Female ; Gene Expression Regulation, Neoplastic ; Genes, Wilms Tumor ; Hematologic Neoplasms ; genetics ; Humans ; Leukemia ; genetics ; Male ; Neoplasm, Residual ; Polymerase Chain Reaction ; Prognosis

OBJECTIVETo investigate the changes in methylation levels of the promoters of the tumor suppressor gene Wilms' tumor gene on the X-chromosome (WTX) and its possible role in gastric cancer.

METHODSWTX promoter methylation levels were detected in 20 pairs of specimens of gastric cancer and matched normal tissues and in 3 gastric cancer cell lines (MGC803, SCG7901, and BGC823) using the Sequenom MassARRAY quantitative analysis system. The gastric cancer cell line BGC823 was treated with 5-aza-2'-deoxycytidine (5-aza-dC) for demethylation and the changes in the level of WTX promoter methylation were investigated.

RESULTSWTX promoter methylation levels were very low and showed no significant differences among normal gastric tissues, gastric cancer tissues and the 3 gastric cancer cell lines. In BGC823 cells, treatment with 5-aza-dC did not obviously affect the promoter methylation levels of WTX.

CONCLUSIONHigh methylation levels of WTX promoters are rare in gastric cancer.

Cell Line, Tumor ; Chromosomes, Human, X ; DNA Methylation ; Genes, Wilms Tumor ; Humans ; Promoter Regions, Genetic ; Stomach Neoplasms ; genetics ; metabolism

OBJECTIVETo study the clinical and pathological features of Denys-Drash syndrome (DDS).

METHODThree DDS cases who were treated in our department from December 2009 to June 2011 were subjected to this study by reviewing of literature.

RESULTBoth case 1 and case 2 were female, with karyotype 46, XX. Case 3 was male with bilateral cryptorchidism. The ages of nephropathy onset of the three cases were 1 year and 9 months, 2 years and 8 moths, and 3 months respectively. Proteinuria in case 2 and case 3 were evidenced to be resistant to steroid. Case 1 was partially responsive to tacrolimus, plasma albumin and cholesterol were improved, although proteinuria was persistent after Tacrolimus was administered. Remission was achieved in case 2 after administration of cyclosporine A and later tacrolimus, and her renal function remains normal till present (4 years and 9 months). Residue renal histology revealed diffused mesangial sclerosis (DMS) in all three patients. All of the three patients had developed right unilateral Wilms tumor. A novel WT1 missense mutation exon 9 c.1213C > G was detected in case 1. WT1 exon 9 c.1168C > T nonsense mutation and exon 8 c.1130A > T missense mutation were detected in case 2 and case 3, respectively.

CONCLUSIONThe clinical manifestation of nephropathy in DDS is variable. The majority present with early onset nephropathy and reach renal failure before the age of 4 years. But in a few patients, nephropathy can also be present much later and progress slowly. Proteinuria in DDS is resistant to steroid but is responsive to calcineurin inhibitors, including Cyclosporine A. The effectiveness of tacrolimus was also observed in this study. DDS is evidently caused by WT1 mutation. DMS is the characteristic renal pathological change in DDS.

Cyclosporine ; therapeutic use ; Denys-Drash Syndrome ; drug therapy ; genetics ; pathology ; Fatal Outcome ; Female ; Genes, Wilms Tumor ; Heterozygote ; Humans ; Infant ; Male ; Mutation ; Nephrotic Syndrome ; drug therapy ; genetics ; pathology ; Proteinuria ; drug therapy ; Sclerosis ; drug therapy ; genetics ; pathology ; Tacrolimus ; therapeutic use ; Treatment Outcome ; WT1 Proteins ; genetics ; Wilms Tumor ; drug therapy ; genetics ; pathology

OBJECTIVETo establish the BGC-823/WTX-EGFP gastric cancer cell line with stable expression of Wilms tumor gene on the X chromosome (MTX) for functional analysis of WTX gene.

METHODSThe full-length WTX cDNA was amplified from human embryonic kidney 293FT cells and cloned into the pEGFP-N1 vector containing the reporter gene of green fluorescence protein. The recombinant pEGFP-WTX expression vector, after digestion by restriction enzyme to identify the size of target gene fragment, was transfected into 293FT cells and the expression of fluorescent reporter gene was observed under fluorescence microscope. pEGFP-WTX vector was transfected into human gastric cancer BGC-823 cell line to establish BGC-823/WTX-EGFP cell line stably expressing WTX. Quantitative RT-PCR and immunocytochemical staining were used to detect the expression of WTX in both BGC-823/WTX-EGFP and control BGC-823 cells.

RESULTSThe recombinant pEGFP-WTX plasmid was successfully constructed and verified by PCR and sequencing. The mRNA and protein expressions of MTX were significantly increased in BGC-823/WTX-EGFP cells as compared with those in the control cells.

CONCLUSIONThe full-length WTX expression vector (pEGFP-WTX) and BGC-823/WTX-EGFP gastric cancer cell line have been successfully established to facilitate further functional study of WTX gene.

Cell Line ; Cell Line, Tumor ; Chromosomes, Human, X ; genetics ; DNA Restriction Enzymes ; DNA, Complementary ; Genes, Wilms Tumor ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; Humans ; Plasmids ; Stomach Neoplasms ; genetics ; Transfection

OBJECTIVETo explore expression ratio alteration between WT1 gene and its isomers during differentiation of leukemia cell line HL-60 induced by all-trans retinoic acid (ATRA) and the relationship existed between them.

METHODSThe degree of cellular maturation was verified by NBT reduction test and immunophenotyping. Expression of unspliced WT1, WT1 (17AA+) and WT1 (KTS+) were determined by real-time fluorescence quantitative RT-PCR during the induced differentiation of HL-60 cells. The relative ratio of four splicing variants WT1 (+/+), WT1 (+/-), WT1 (-/+), WT1 (-/-) were analyzed.

RESULTSDuring the induced differentiation of HL-60 cells, NBT reduction rate and CD11b positive rate increased significantly (P < 0.05 and P < 0.001, respectively). The expression of WT1 gene decreased from (4.17 +/- 2.21) x 10(-3) at 0 hour to (7.53 +/- 2.30) x 10(-4) at the 96th hour. The ratio of 17AA+decreased from 0.60 +/- 0.05 at 0 hour to 0.42 +/- 0.08 at the 96th hour. The ratio of KTS+ decreased from 0.53 +/- 0.08 at 0 hour to 0.41 +/- 0.04 at the 96th hour. The ratio of WT1 (+/+) decreased gradually from 0.32 +/- 0.06 at 0 hour to 0.17 +/- 0.03 at the 96th hour. Change of ratios of other two isomers not significant.

CONCLUSIONSDuring the induced differentiation of HL-60 cells, WT1 gene expression decreases gradually. The phenotype of the majority of uninduced HL-60 cells is WT1 (+/+), in contrast to WT1 (-/-) phenotype after the induction of cell differentiation, indicating that WT1 gene may participate in the regulation of hematopoietic cell differentiation through modulation of the expression ratios of its four spliced variants.

Antineoplastic Agents ; pharmacology ; CD11b Antigen ; metabolism ; Cell Differentiation ; drug effects ; Gene Expression Regulation, Neoplastic ; Genes, Wilms Tumor ; HL-60 Cells ; Humans ; Protein Isoforms ; genetics ; metabolism ; Tretinoin ; pharmacology ; WT1 Proteins ; genetics ; metabolism

We experienced a female neonate with congenital nephrotic syndrome (CNS) associated with congenital diaphragmatic hernia (CDH). Because of the rare combination of two conditions, we report this case with literature review. CDH was found immediately after birth and emergency operation was done for hernia repair. But on the next day, generalized edema and oliguria(0.59 mL/kg/hour) was found and her blood chemistry showed hypoalbuminemia (1.6 g/dL), increased BUN (27.7 mg/dL) and serum creatinine( 1.8 mg/dL) along with heavy proteinuria (4+). We started albumin infusion with a bolus of intravenous furosemide. We suspected the neonate had congenital nephrotic syndrome and her 24hr urine protein was 1,816 mg/day. In spite of immunosuppressive therapy, the nephrotic syndrome and renal failure progressed. We started peritoneal dialysis on the day of life 22 but it was not satisfactory. She was complicated by intracranial hemorrhage and multi-organ failure and expired at 34 days of age. Kidney necropsy was performed which showed diffuse mesangial sclerosis (DMS). Her chromosome study revealed 46, XX and her gene study revealed a heterozygous missense mutation, Arg366His, in Wilms tumor suppressor gene (WT1). This case deserves attention on account of the 4th case of CNS with CDH revealing the Arg366His mutation in the WT1 gene andG the 1st case of early onset renal failure without male pseudohermaphroditism and Wilms tumor with CNS, CDH and the Arg366His mutation in the WT1 gene. So, this report gives support to the hypothesis that Arg366His mutation in the WT1 gene can result in CNS and CDH.
46, XY Disorders of Sex Development ; Edema ; Emergencies ; Female ; Furosemide ; Genes, Suppressor ; Hernia, Diaphragmatic ; Herniorrhaphy ; Humans ; Hypoalbuminemia ; Infant, Newborn ; Intracranial Hemorrhages ; Kidney ; Mutation, Missense ; Nephrotic Syndrome ; Parturition ; Peritoneal Dialysis ; Proteinuria ; Renal Insufficiency ; Sclerosis ; Wilms Tumor