性连锁凋亡抑制蛋白及其拮抗蛋白在急性白血病中的表达及意义

Expression and Significance of X-linked Inhibitor of Apoptosis Protein and Its Antagonized Proteins in Acute Leukemia

为了研究急性白血病(AL)性连锁凋亡抑制蛋白(X-linkedinhibitorofapoptosisproteins,XIAP)和XIAP相关因子1(XIAP-associatedfactor1,XAF1)的表达及其临床意义,应用逆转录聚合酶链反应(RT-PCR)法检测116例AL患者和17名正常人骨髓单个核细胞中XIAP、XAF1、Smac和HtrA2mRNA的表达,并分析其与临床治疗效果的关系。结果表明初治AL患者XIAPmRNA表达水平(0.990±0.337)明显高于正常对照(0.395±0.148)(P<0·01);初治AL患者XAF1mRNA阳性率及表达水平(56.3%,0.246±0.267)明显低于正常对照(100%,0.964±0.387)(P<0.01);69例初治AL患者中高表达XIAP患者完全缓解率明显低于低表达患者(P<0.01);XAF1阳性表达患者完全缓解率明显高于阴性表达患者(P<0.01)。结论XIAP在AL中异常高表达,XAF1在AL中异常低表达,XIAP高表达及XAF1低表达或阴性可能是AL患者不良预后的指标。

To investigate the expression and significance of X-linked inhibitor of apoptosis protein （XIAP） and XIAP-associated factor 1 （XAF1） in acute leukemia, the expression of XIAP, XAF1, Smac, and HtrA2 mRNA in the bone marrow aspirates from 87 newly diagnosed AL patients, 23 patients in remission, 6 patients in relapse, and 17 normal controls were detected by means of reverse transcriptase polymerase chain reaction （ RT-PCR）, and their relationship with clinical therapeutic efficiency was analyzed. The results showed that the expression level of XIAP mRNA in newly diagnosed AL patients （0.990 ± 0. 337 ） was significantly higher than that in normal controls （0.395 ± 0. 148 ） （P 〈 0. 01 ） ; the positive rate and expression level of XAF1 mRNA in newly diagnosed AL patients （ 56. 32%, 0. 246 ± 0. 267 ） were significantly lower than that in normal controls （ 100%, 0. 964 ± 0. 387） （ P 〈 0.01 ）. In 69 out of 87 newly diagnosed AL patients, efficacy remained evaluable. AL patients with high level of XIAP achieved a lower complete remission （CR） rate than patients with low level of XIAP （54.55 % and 86.11%, respectively） （ P 〈 0. 01 ）. XAF1 positive patients achieved a higher CR rate than XAF1 negative patients （86. 84% and 51.61%, respectively） （P 〈 0. 01 ）. It is concluded that the overexpression of XIAP and negativity of XAF1 may be two adverse prognostic factors in AL patients.