增殖细胞核抗原、ras癌基因产物P21与白血病的相关性

Interrelation of Proliferation Cell Nuclear Antigen,ras-P21 and Leukemia

目的探讨急性白血病及骨髓增生异常综合征(MDS)患者增殖细胞核抗原(PCNA)、ras-P21表达的相关性及其临床意义。方法采用单克隆抗体免疫细胞化学染色技术(SP法)检测33例急性髓细胞白血病(AML)、18例急性淋巴细胞白血病(ALL)、25例MDS及10例正常人的增殖细胞核抗原(PCNA)及ras-P21的表达,分析其相关性。结果AML、ALL及MDS PCNA的阳性率分别为62%,56%和53%,三者阳性率差别无统计学意义(P>0.05)。AML与ALL、AML与MDS的PCNA表达强度(阳性细胞%)差别无统计学意义(χ2值分别为2.027和0.5217)。2例半年内转化成AML的MDS患者为PCNA高表达。17例ras-P21阳性者均有PCNA表达。结论ras-P21和PCNA共同表达的白血病细胞增殖活性及恶性增殖的潜能更高,ras-P21和PCNA综合检测对于白血病细胞增殖活性和预后分析可能具有参考价值。

Objective To explore the expression and clinical significance of proliferation cell nuclear antigen（PCNA） and ras-P21 in patients with acute leukemia and myelodysplastic syndrome（MDS）. Methods Monoclonal antibody was used to detect the expression of PCNA and ras-P21 leukemic cells and MDS. Results The PCNA positive rate in acute myeloblastic leukemia（AML）, acute lymphocytic leukemia（ALL） and MDS was 62%, 56% and 53% respectively. The difference of PCNA positive rate in them was no significant. 2 patients with high PCNA expression in MDS transformed to AML in half of a year. 5 of the ras-P21 positive patients in MDS transformed to AML in 2- 12 months. But most of the patients with ras-P21 negative in MDS remained stable in 12-60 months. 17 ras-P21 positive cases had PCNA expression. Conclusion The leukemic cells with higher PCNA and ras-P21 expression may have higher proliferative activity and higher pernicious potential; detecting the expression of PCNA and ras-P21 in leukemic cells would be of benefit in diagnosing and predicting the prognosis of patients with leukemia.