Survivin在儿童急性白血病骨髓及外周血单个核细胞中的表达及意义

Expression and clinical value of surviving in mononuclear cells of bone marrow and peripheral blood of children with acute leukemia

目的研究survivin在急性白血病(AL)儿童骨髓及外周血单个核细胞(MNC)的表达情况及意义。方法应用RT-PCR的方法检测21例AL患儿骨髓及外周血MNC中survivin mRNA的表达。结果12例初诊AL患儿骨髓MNC中survivin阳性表达6例(50%);11例外周血MNC中survivin阳性表达4例(36.37%),均明显高于对照组(P<0.05)。初诊组急性淋巴细胞白血病(ALL)和急性髓细胞白血病(AML)患儿survivin表达无显著差异(P>0.05)。完全缓解组患儿中1例骨髓survivin阳性表达(11.11%),明显低于初诊组(P<0.05),该例患儿7周后复发。AL初诊组4例外周血MNC survivin阳性表达者与7例阴性表达者外周血原始和/或幼稚细胞平均值分别为(76.43±43.28)×109/L和(5.86±13.85)×109/L,有显著性差异(P<0.05)。结论①Survivin在AL初诊患儿骨髓及外周血MNC中高表达,提示survivin可能参与了儿童AL的发生发展;②完全缓解患儿骨髓survivin阳性表达可能可作为AL复发的早期指标。

Objective To study the survivin expression in mononuclear cells of both bone marrow and peripheral blood in childhood acute leukemia （AL）. Methods Twenty-one children with AL were divided into newly diagnosed group （ n = 12） and complete remission （CR） group （ n = 9）. The control group was consisted of 15 children without tumor. Mononuclear cells were separated from bone marrow and peripheral blood （PBL） by gradient density centrifugation and RNA was extracted, and RT-PCR was performed to detect survivin mRNA. Results In newly diagnosed AL group, 6 out of 12 patients had positive survivin expression in bone marrow （50%） and 4 out of 11 patients in the PBL （36.37%）, both of which were higher than the control group （P 〈 0. 05 ）. There was no significant difference of the positive expression of survivin between the newly diagnosed ALL and AML patients （P 〉 0.05）. In 9 CR patients, all the patients had the negative expression in the PBL, but 1 positive expression in bone marrow （ 11. 11% ）. The positive expression in CR group was significantly lower than the newly diagnosed AL group. The only one patient with positive survivin expression in CR group had relapse 7 weeks later. In newly diagnosed patients, the average immature leukocytes were （76.43 ± 43.28） × 10^9/L in the patients with positive survivin expression and （13. 85 ± 5.86） × 10^9/L in those with negative survivin expression （ P 〈 0. 05 ）. Conclusion The higher expression of survivin may contribute to the pathogenesis and the progress of the leukemia. The positive expression of survivin in CR group is much lower than newly diagnosed group. The positive survivin expression in CR group which is much lower than the newly diagnosed group may be an early signal of AL relapse.