急性非淋巴细胞白血病细胞核仁组织区相关嗜银蛋白的研究

Study of argyrophilic nucleolar organizer region proteins in acute myeloid leukemia cells

目的研究核仁形成区相关嗜银蛋白(Ag-NORs)对评估急性非淋巴细胞白血病(AML)细胞增殖分化水平的价值。方法用嗜银染色方法检测AML细胞的嗜银颗粒数目和形态,观察Ag-NORs形态与细胞形态学之间的关系,Ag-NORs分数与染色体、荧光分子原位杂交(FISH)检查以及AML预后的关系。结果不同Ag-NORs形状特征的细胞比例与细胞形态学的原幼稚细胞比例有显著相关性。Ag-NORs分数比较,染色体和FISH检查异常组高于正常组;治疗前未缓解组高于缓解组;持续缓解1年以上组高于1年内复发组;生存期1年以上组高于1年内死亡组(均P<0.01)。结论用嗜银染色方法检测AML细胞Ag-NORs分数和形态可观察白血病细胞的增殖状况,可作为白血病细胞动力学研究的一项指标,由于操作简便和易于普及,可为白血病的临床诊治提供快捷有效的实验依据。

Objective To explore the value of argyrophilic nucleolar organizer region proteins （Ag-NORs） in the evaluation of proliferation and differentiation of acute myeloid leukemia （AML） cells. Methods The number and morphology of Ag-NORs of AML cells were deteeteed by argyrophilic staining method. The relationship between the morphology of Ag-NORs and that of AML cells was observed, and the relationship between the scores of Ag-NORs and chromosome, fluorescence in situ hybridization （FISH） results and prognosis of AML was explored. Results The cell ratios of Ag-NORs with different morphologic characteristics were significantly correlated with those of the myeloblast cells and juvenile cells. The scores of Ag-NORs were higher in group of abnormal chromosome and FISH inspection than in normal group; the scores of pre-treatment Ag-NORs were higher in non-remission （NR） group than in complete-remission （CR） group; after remission induction therapy, the scores of those with sustained CR for more than one year were higher than those with relapse within one year; the scores of those survival for more than one year were higher than those survival for less than one year （ all P 〈 0.01）. Conclusion The proliferation of AML cells can be observed by detection of Ag-NORs scores and morphology with argyrophilie staining method, which may serve as an index for dynamics research of leukemia cells. It provides an effective experimental basis for the clinical diagnosis and treatment of leukemia due to the feature of conveniece.