XIAP在成人急性淋巴细胞白血病中的表达及其意义

Expression and Clinical Significance of the X-linked Inhibitor of Apoptosis Protein (XIAP) in Adult Acute Lymphocytic Leukemia

目的探讨X连锁凋亡抑制蛋白(XIAP)在成人急性淋巴细胞白血病(ALL)中的表达及其临床意义。方法选取63例ALL患者,初治者37例[B-ALL29例,T-ALL8例;ph(+)-ALL12例,ph(-)-ALL25例]为初治组,血液学完全缓解(CR)者15例(CR组),复发者11例(复发组)。应用半定量逆转录-聚合酶链反应(RT-PCR)检测ALL骨髓标本XIAP基因表达水平,以20例非恶性血液病患者骨髓标本为对照组。结果初治组XIAP基因表达水平高于CR组和对照组(P<0.05),与复发组相比差异无统计学意义(P>0.05);B-ALL患者XIAP表达水平与T-ALL比较差异无统计学意义(P>0.05);ph(+)-ALL患者XIAP表达水平高于ph(-)-ALL(P<0.05);初治组XIAP高表达者较低表达者CR率明显下降(P<0.05)。结论ALL患者XIAP基因高表达,提示XIAP可能通过抑制白血病细胞凋亡参与了ALL的发生发展,为ALL的治疗提供了新思路。XIAP高表达可能是急性淋巴细胞白血病预后不良的指标之一。

Objective To investigate the expression and clinical significance of the X-linked inhibitor of apoptosis protein （XIAP） in adult acute lymphocytic leukemia（ALL）. Methods 63 patients from ALL were divided into 3 groups,newly diagnosed group（B-ALL 29 cases,T-ALL 8 cases, ph（＋）-ALL 12 cases, ph（-）-ALL 25 cases） with 37 cases, complete remission group with 15 cases and relapsed group with 11 cases. 20 patients without malignant blood disease were enrolled as control group. The expression level of XIAP in bone marrow samples of all these cases was detected by semi-quantitative reverse transcription polymerase chain reaction （RT-PCR）. Results The XlAP expression level in the bone marrow of newly diagnosed group are significantly higher than which in complete remission and control group（P〈0.05） ,compared with which in relapsed group,the difference has no statistical significance （P〉0.05）. The difference of XIAP expression level between B-ALL and T-ALL has no statistical significance （P〉0.05）. The expression level of XIAP in ph（ ＋）-ALL Was higher than ph（-）-ALL, the difference has statistical signi-ficance（P〈0.05）, patients in newly diagnosed group with lower XIAP expression level can obtain higher complete remission rate（P〈0. 05）. Conclusions Abnormal expression of XIAP may contribute to the pathogenesis and development of acute lymphocytic leukemia, which may provide a novel strategy for the therapy of ALL. The expression level of XIAP may become one of the prognosis indexes of ALL.