凋亡抑制蛋白survivin在白血病细胞中的表达及其意义

Expression and clinical significant of inhibitor of apoptosis protein,survivin,in leukemia

目的探讨白血病原代细胞中凋亡抑制蛋白survivin基因的表达情况,及其与疗效的关系。方法应用逆转录-聚合酶链反应(RT-PCR)方法检测45例白血病患者和10例健康人骨髓中survivin的表达水平,并给与合适的方式化疗,评判疗效。结果白血病细胞中survivin mRNA阳性率为68.9%(31/45)。急性淋巴细胞白血病(ALL)细胞中survivin mRNA表达阳性率为73.3%,较急性髓系白血病(AML)的63.6%稍高;慢性粒细胞白血病(CML)患者中survivin mRNA表达率很高,可达80.0%,慢性淋巴细胞白血病(CLL)中则为66.7%,但均高于正常对照组的20.0%(P<0.05)。在22例AML患者中,survivin mRNA表达阴性者接受2个疗程化疗后缓解率(CR)87.5%,明显高于表达阳性患者的64.3%。在15例ALL患者中也有类似的结果,CR分别为100%和81.8%。CML患者中,survivin mRNA阳性的4例中有2例两年内发生急变;CLL患者病情均较稳定。结论survivin基因在白血病细胞中有较高的表达,并与疗效及预后有密切的关系。

Objective To explore the correlation between expression oi survlwn genem leukemia and its clinical effects. Methods By using reverse transcription polymerase chain reaction,survivin gene expression in 45 previously untreated leukemia patients and 10 normal people was analyzed. Then all leukemia patients received chemotherapy and assess the effect. Results The positive rate of survivin gene in leukemia was 68.9% （31/45） ,and it was highly beyond that in normal bone marrow mononuclear cells which was 20.0% （ P 〈 0.05 ）. The expression level was higher in ALL cells than in AML cells （73.3% vs 63.6% ）. The survivin expression could get to 80.0% in CML,and CLL could reach 66.7%. Among 22 cases of AML,clinical remission（CR） rate was higher in survivin gene negative expression cells from patients who accepted two courses of chemotherapy than in positive expression cells （87.5% vs 64.3% ）. Similar result could find in ALL patients,clinical remission rate were 100.0% and 81.8%. Among four survivin gene positive CML patients, two people entrance acute transformation phase. The CLL patient＇ s condition was all stable. Conclusion The survivin gene expression was high ir. leukemia,and it had close relationship with curative effect and prognosis.