急性髓系白血病H-ras表达和点突变─流式细胞术和聚合酶链反应比较研究

Expression and Point Mutation of H-RAS in Acute Myeloid Leukemia: A Comparative Study by Flow Cytometry and Polymerase Chain Reaction

目的：了解急性髓系白血病细胞H－rasP21表达与点突变的相关性，以及免疫组化法的临床实用价值。方法：用流式细胞术（FCM）分析67例初治急性髓系白血病（AML）H－rasp21表达；对所有P21阳性和部分P21阴性者作聚合酶链反应（PCR），观察H－ras15位密码子点突变。结果：67例AMLFCMP21阳性者45例（67．2％），P21阴性者22例（32．8％）。P21阳性45例中高表达者22例（48．9％），16例（72．7％）检出H－ras15位密码子点突变，11例（50％）完全缓解（CR）。10例P21阴性和23例P21＋低表达均无H－ras15位密码子点突变，CR率分别为77．2％和87．2％。结论：FCMP21高表达者常有H－ras15位密码子点突变，CR低，H－ras点突变与免疫组化P21＋高表达相关良好，提示AML转归不良。

Objective: To study the correlation between the expression of H-ras P21 and H-ras point mutation and to evaluate the significance of immunohistochemical method. Methods: Flow cytometry (FCM) was used for studying the expression of H-ras P21 in 67 patients of actue myeloid leukemia(AML) de novo,and polymerase chain reaction(PCR)for detecting the point mutation at codon 15 of H-ras. Results:45(67.2%) out of 67 cased were positive for P21 and 22(32.8%)negative for P21 by FCM. 22 out of 45 P21＋ cases showed high P21 expression and revealed point mutation at codon 15 of H-ras in l6 (72. 7%),including 11(50%) CR cases. No point mutation at codon 15 of H-ras was found in 10 P21－ and 23 low P21 expression cases. 17 (77.2%) out of 22 P21－ and 20(87.2%) out of 23 low P21＋ cases entered CR. Conclusion: High expression of P21 by FCM frequently had H-ras point mutation at codon 15 with low CR rate. H-ras point mutation correlated well with high P21 experession indicating poor outcome in AML.