凋亡抑制蛋白XIAP与Survivin在儿童急性白血病中的表达

The expressions of inhibitor-of-apoptosis protein XIAP,Survivin in childhood acute leukemia

目的探讨凋亡抑制蛋白XIAP,Survivin在儿童急性白血病(AL)中的表达及其临床意义。方法54例AL患儿,其中初诊未治26例,治疗后完全缓解(CR)23例,复发5例。应用免疫组织化学方法检测其骨髓细胞XIAP,Survivin蛋白表达。对照组为10例非恶性血液病患儿。结果(1)XIAP,Survivin蛋白在初诊未治AL患儿骨髓中表达水平均高于缓解期(P<0.05,0.008)和对照组(P<0.05,0.008),与复发组相比均无显著性差异(P>0.05,0.008)。XIAP在缓解期仍高于对照组(P<0.05),Survivin在缓解期和对照组相比无显著性差异(P>0.008)。(2)初诊未治AL患儿XIAP,Survivin蛋白表达在急性淋巴细胞白血病(ALL)和急性髓细胞白血病(AML)组比较无显著性差异(P>0.05)。(3)初诊未治AL患儿XIAP,Survivin蛋白表达显著正相关(r=0.923,P<0.001)。结论(1)儿童AL XIAP,Survivin蛋白高表达,提示二者可能通过抑制肿瘤细胞的凋亡参与了AL的发生发展,为儿童AL的治疗提供了新思路。(2)XIAP,Survivin蛋白表达可能与AL的临床分型无关,有希望成为AL的诊断性指标。(3)初诊未治AL患儿XIAP,Survivin蛋白表达显著正相关,提示XIAP,Survivin在儿童AL的发生与发展中可能互相影响。

Objective To investigate the expressions and clinical significance of inhibitor-ofapoptosis protein XIAP, Survivin in childhood acute leukemia （AL）. Methods The expressions of XIAP, Survivin proteins were detected by immunohistochemical assay in 54 children with AL, including 26 newly diagnosed and untreated AL children, 23 children in remission and 5 relapsed children. The control included 10 children without malignant blood disease. Results （ 1 ） The protein levels of XIAP, Survivin in the bone marrow of newly diagnosed AL children are all higher than those in remission and normal controls （P 〈 0. 05, 0. 008） , compared with those in relapsed children , the differences have no statistical significance（P 〉 0.05, 0. 008）. The protein level of XIAP in remission is higher than that in normal controls （ P 〈 0.05 ） , but the level of Survivin in remission is not higher than that in normal controls, the difference has no statistical significance （P 〉 0. 008 ）. （2）Compare the protein levels ofXIAP, Survivin in ALL and AML in newly diagnosed AL children, the differences have no statistical significance（P 〉0. 05 ）. （3）The protein level of XIAP in newly diagnosed AL children is positively correlated with Survivin （ r = 0. 923, P 〈 0. 001 ）. Conclusion （ 1 ） The differences of XIAP, Survivin protein expressions in the different periods of AL children and normal controls shows that XIAP, Survivin function to the genesis and development of AL in children. （2） The levels of XIAP, Survivin proteins may not be correlated with the types of AL. It＇ s hopeful for them to become diagnostic indexes. （3） XIAP, Survivin may affect each other in the genesis and development of AL in children.