细胞周期蛋白依赖激酶抑制因子P21^(WAF1)、P27^(KIP1)在急性白血病的表达及其意义

Expression and Clinical Significance of Cyclin Kinase Inhibitor P21^(WAF1) and P27^(KIP1) in Children with Acute Leukemia

目的探讨细胞周期蛋白依赖性激酶抑制因子P21WAF1、P27KIP1在急性白血病的表达情况及其临床意义。方法采用免疫细胞化学S-P染色法测定32例白血病患儿骨髓单个核细胞P21WAF1、P27KIP1的表达情况,分别观察阳性率及表达强度。结果32例白血病骨髓涂片标本中P21WAF1或P27KIP1在ALL、AML及总标本中表达阳性率均低于对照组(P均<0.05)。阳性病例P21WAF1阳性细胞百分率在ALL与AML中无差异,但积分显示阳性程度AML弱于ALL;P27KIP1阳性细胞率及积分在ALL及AML中均无显著差异(P均>0.05)。随访观察部分病例,经诱导化疗达到完全缓解后随访,两种蛋白有阳转或表达增强现象。结论P21WAF1、P27KIP1低表达参与急性白血病的发生发展;随临床缓解,P21WAF1、P27KIP1表达增强,提示P21WAF1、P27KIP1可能作为化疗疗效的分子学指标。

Objective To investigate the expression of cyclin kinase inhibitor P21^WAF1 and P27^KIP1 in children with acute leukemia and its clinical significance. Methods A total of 32 hospitalized children with acute leukemia（AL） were included in this study. Their bone marrow samples were collected before chemotherapy and individual patient was detected after complete remisssion （CR）. The method of immunocytochemistry was used to estimate the expression of P21^WAF1 and P^27KIP1.Both positive percentage and intensity of the cells were counted. Results Findings showed that the positive ratios of P21^WAF1 and P^27KIP1 in total samples , ALL samples and AML ,samples were lower than the control group（P 〈 0.05）. In positive cases, the percentage of P^21WAF1 positive cells showed no difference in ALL and AML ,samples, while integral positive ratio in AML was lower than that in ALL. There was no difference in P^27KIP1 integral positive cell ratio between ALL and AML. Some patients had CR after chemotherapy by follow up survey and the proteins showed positive transfomation or higher expression. Conclusions The study indicates that P^21WAF1 and P^27KIP1 had a lower expression in the pediatric patients with lankemia,which might contribute to the pathogenesis and the progress of the leukemia. The followup study also sugges that P^21WAF1. P^27KIP1 may be a molecular marker for the evaluation of the chemotherapy tratment.