bcl-x和bcl-2基因在急性白血病患者中的表达及其临床意义

Detection and evaluation of bcl-x and bcl-2 gene expression in blasts from patients with acute leukemia

目的 观察凋亡调控基因bcl x和bcl 2在急性白血病 (AL)患者中的表达 ,探索AL的病理和化疗反应的分子机制。方法 应用半定量逆转录 聚合酶链反应 (RT PCR)技术检测bcl x(bcl xL、bcl xS)和bcl 2在 34例AL患者中mRNA水平的表达。结果 抑凋亡基因bcl xL 和bcl 2在AL细胞中的表达比在完全缓解和正常对照者骨髓细胞中的表达明显增高 (P <0 0 1) ,同时在复发患者AL细胞中的表达水平分别是初治患者的 1 8倍和 1 9倍 (P <0 0 1)。bcl xL 和bcl 2的表达以及bcl xL 和bcl xS 的表达均呈正相关 (P <0 0 1) ,但个体间有较大差异。未发现bcl xS 表达水平与AL的复发和疗效有关 ;治疗无效患者bcl xL 和bcl 2的表达比治疗有效者高 (P <0 0 1) ,bcl xL、bcl 2和此两基因同时高表达的患者临床治疗无效率分别为 80 0 %、91 7%和10 0 0 %。结论 AL的发病可能与抑凋亡基因bcl xL 和bcl 2的高表达有关 ;bcl xL 或bcl 2的高表达可以降低AL的化疗敏感性 。

Objective To investigate the expression of bcl x and bcl 2 genes in bone marrow cells of acute leukemia and their effects on response to chemotherapy Methods Semi quantitative reverse transcription polymerase chain reaction (RT PCR) was used to detect the mRNA expressions of bcl x L, bcl x S and bcl 2 in blast cells from 34 acute leukemia(AL) patients Results The expression of bcl x L and bcl 2 or both in blast cells from 34 AL patients was higher than that in complete remission patients and normal subjects The expression of bcl x L and bcl 2 in relapsed patients was increased by 1 8 and 1 9 fold, respectively, compared with that in the newly diagnosed patients(P< 0 01) However, no relationship was found between the expression of bcl x S and the relapse and chemotherapeutic response of the AL patients There were positive correlations between the expression of bcl x L and bcl 2 or bcl x L and bcl x S The expression level of bcl x L and bcl 2 in the patients with poor response to chemotherapy was significantly higher than that in the patients with better response Treatment failure occurred in 80 0%, 91 7%and 100 0%of the patients with overexpression of bcl x L and bcl 2 and both, respectively Conclusion Overexpression of bcl x L and bcl 2 may imply the lower sensitivity of the leukemic cells to chemotherapy and higher risk of relapse