抗凋亡蛋白XIAP和促凋亡蛋白Smac在急性淋巴细胞白血病患儿中表达的意义

Significance of Expressions of Anti-Apoptosis Protein X-Linked Inhibitor of Apoptosis Protein and Pro-Apoptosis Protein Second Mitochondria Derived Activator of Caspase in Children with Acute Lymphoblastic Leukemia

目的通过检测抗凋亡蛋白XIAP和促凋亡蛋白Smac在ALL患儿中的表达,探讨XIAP、Smac在儿童ALL中的临床意义。方法 92例ALL患儿,其中初治组46例,缓解组28例,复发组18例。对照组为25例骨髓像正常的非恶性血液病患儿。应用SP-免疫组织化学方法检测初治组、缓解组、复发组及对照组骨髓抗凋亡蛋白XIAP、促凋亡蛋白Smac表达情况。应用SPSS 11.5软件进行统计学分析。结果 1.XIAP、Smac在初治ALL患儿骨髓中表达水平均高于缓解组(P<0.05,P<0.008)和对照组(P<0.05,P<0.008),与复发组比较差异均无统计学意义(Pa>0.05)。2.初治ALL患儿骨髓XIAP低表达(XIAPlow)者完全缓解率明显高于XIAP高表达(XIAPhigh)患儿(P<0.05);Smac表达阴性(Smac-)患儿完全缓解率明显高于Smac表达阳性(Smac+)患儿,差异有统计学意义(P<0.05)。结论 XIAPhigh、Smac+在ALL的发病中可能发挥着重要作用,XIAPhigh、Smac+可能为ALL患儿预后不良的因素之一。

Objective To investigate the expressions of anti-apoptosis protein X-linked inhibitor of apoptosis protein（XIAP） and pro-apoptosis protein second mitochondria derived activator of caspase（Smac） in children with acute lymphoblastic leukemia（ALL）,and to explore their clinical significance.Methods The expressions of XIAP and Smac were measured by immunohistochemical assay in 92 children with ALL,including 46 newly diagnosed and untreated ALL children,28 children in complete remission（CR） and 18 relapsed children.Other 25 children without malignant blood disease and with normal bone marrow were selected as normal controls.SPSS 11.5 software was used to analyze the data.Results 1.The positive rate expression intensity of XIAP and Smac in the bone marrow of newly diagnosed ALL children were both higher than those in remission（P〈0.05,P〈0.008） and normal controls（P〈0.05,P〈0.008）,compared with those in relapsed children,the difference had no statistical significance（Pa0.05）.2.In newly diagnosed ALL children,the CR rate of the low expression of XIAP（XIAP low） was higher than that of high expression of XIAP（XIAPhigh） in children with ALL cells（P〈0.05）;The CR rate of the negative expression of Smac（Smac^-） was higher than that of the positive expression of Smac（Smac^＋） in children with ALL cells（P〈0.05）.Conclusions XIAPhigh,Smac^＋ may play synergic roles in the pathogenesis of ALL and higher risk of relapse.XIAPhigh,Smac^＋ can serve as markers of poor prognosis in ALL.