急性白血病Bcl-2、P170、CD_(34)表达及临床预测价值的研究

Clinical Predictive Significance of the Expression of Bcl- 2, P170 and CD)(34) in Acute Leukemia

目的分析和评估急性白血病Bcl－2、P170、CD_(34)表达的临床预测价值。方法用ABC免疫细胞化学法检测42例急性白血病Bcl－2、P170、CD_(34)的表达。结果Bcl－2、P170、CD_(34)高表达的急性白血病完全缓解（CR）率低于低表达或不表达者（45．5％V77．4％，50．0％v78．6％，57．1％v75．0％，P＜0．05），未CR和早期复发率高，分别为81．8％，78．6％，64．3％。化疗2个疗程达CR者Bcl－2、P170的高表达率高于化疗1个疗程达CR者（36．4％v5．6％，45．5％v11．1％，P＜0．05）。Bcl－2与急性白血病预后的阳性符合率为90．9％，略高于P170、CD_(34)。同时检测3项指标的阳性、阴性及总符合率分别为100％、80％及84．6％。结论Bcl－2、P170、CD_(34)的高表达均预示急性白血病的预后不良。Bcl－2可作为预测急性白血病疗效、预后较敏感的指标，多指标联合检测预测价值更高。

Objective To investigate the clinical predictive value of the expression of Bcl- 2, P170 and CD34 in acute leukemia (AL) .Methods 42 patients with AL were detected for the expression of Bcl -2,P170 and CD34 by AvidinBiotin peroxidase immunocytochemistry technique, Results The CR rates in patients with over expression of Bcl-2, P170and CD34 was lower than that of those with low-/non-expression of Bcl-2, P170 and CD34(45. 5% v 77. 4, 50. 0% v78 .6%,57.1 % v 75 .0%, P < 0.05, respectively), their early recurrent rates were high(81. 8%,78.6%, 64.3%, respectively). The over-expression rate of Bcl-2 or P170 in the patients with CR after two treatmental courses was higher than those after one treatmetnal course(36.4% v 5.6%,45.5% v 11. 1%, P < 0.05) .The positive coincident rate of Bcl-2 with the prognosis of AL was 90.9%, which was a little higher than that of P170 or CD34. The positive, negative and total coincident rates of the combined detection of the three markers were 100%, 80% and 84.6%, respectively, Conclusions The overexpression of Bcl-2, P170 or CD34 could result in poor prognosis of AL. There was more sensitivity of Bcl-2 in predicitng the treatmet effect and prognosis of AL, and the predictive value was improved by their combined detection.