cAMP反应元件结合蛋白/Bcl-2在小儿急性白血病骨髓细胞中的表达及意义

Expression of CREB/Bcl-2 in bone marrow mononuclear cells of children with acute leukemia

目的探讨cAMP反应元件结合蛋白(CREB)和Bcl-2在小儿急性白血病骨髓细胞中的表达及临床意义。方法92例急性白血病患儿和30例非恶性血液病患儿(对照组)纳入研究。采用RT-PCR和Western blot检测CREB和Bcl-2在骨髓单个核细胞内的表达。结果CREB和Bcl-2在急性白血病患儿骨髓中的表达明显高于对照组(P<0.01);CREB和Bcl-2在急性淋巴细胞白血病(ALL)和急性髓细胞白血病(AML)患儿骨髓中表达差异无统计学意义;髓外浸润组患儿骨髓CREB和Bcl-2的表达明显高于非髓外浸润组患儿(P<0.05);完全缓解组CREB和Bcl-2的表达显著低于非完全缓解组(P<0.01);急性白血病组患儿骨髓CREB和Bcl-2 mRNA的表达与外周血白细胞计数呈正相关,相关系数分别为0.62和0.71(P<0.05);CREB和Bcl-2 mRNA和蛋白表达分别呈正相关,相关系数分别为0.75和0.68(P<0.05)。结论CREB和Bcl-2表达可能与小儿白血病发病机制和临床预后存在相关性,但可能与小儿急性白血病类型无相关性。

Objective To study the expression and role of cyclic-AMP response binding protein （CREB） and Bcl-2 in children with acute leukemia.Methods Ninety-two children with acute leukemia （leukemia group） and 30 children with non-hematologic malignancies （control group） were enrolled. The mRNA and protein expression of CREB and Bcl-2 in bone marrow mononuclear cells were measured by reverse transcriptase polymerase chain reaction （RT-PCR） and Western blot.Results The mRNA and protein expression of CREB and Bcl-2 in the leukemia group was significantly higher than that in the control group （P0.01）. There were no significant differences in the expression of CREB and Bcl-2 between acute lymphoblastic leukemia and acute myeloid leukemia subgroups. At the initial diagnosis, the mRNA and protein expression of CREB and Bcl-2 in children with extramedullary infiltration was higher than that in children without （P0.05）. In the leukemia group, the mRNA and protein expression of CREB and Bcl-2 in the complete remission subgroup was significantly lower than that in the non-complete remission subgroup （P0.01）. High mRNA expression of CREB and Bcl-2 in the leukemia group was positively correlated with peripheral blood leucocyte counts （r=0.62, 0.71 respectively, P0.05）. There was a positive correlation between mRNA and protein expression of CREB and Bcl-2 （r=0.75, 0.68 respectively; P0.05 ）.Conclusions The expression of CREB and Bcl-2 may be correlated with the pathogenesis and clinical prognosis of childhood leukemia, however, their expression may not be associated with the classification of acute leukemia.