白血病细胞Ki-67表达和AgNORs计数及其临床意义

THE EXPRESSION OF Ki 67 AND AgNORs IN LEUKEMIA CELLS AND THEIR CLINICAL RELEVANCE

目的 :研究人骨髓白血病细胞中增殖相关抗原 Ki- 6 7的表达和核仁形成嗜银蛋白 ( Ag NORs)及其与病程的关系。方法 :采用免疫组化 ABC法和一步银染技术 ,分别检测 2 1例正常骨髓和 75例白血病骨髓细胞中Ki- 6 7的表达和 Ag NORs,并动态观察它们在白血病不同阶段的变化。结果 :不同类型白血病细胞的 Ki- 6 7指数分别为 2 .5 % ( AML )、12 .2 % ( AL L )、17.2 5 % ( CML ) ,均显著低于正常骨髓原早幼细胞 Ki- 6 7指数 ( 2 3.2 % ) ;不同类型白血病的 Ag NORs分别为 3.6 0± 0 .6 3( AML )、3.44± 0 .5 8( AL L ) ,均显著高于正常对照组 ( 1.90± 0 .40 ) ;白血病化疗前 Ki- 6 7指数高者 ,缓解率高 ;白血病达完全缓解后 ,Ki- 6 7指数和 Ag NORs接近正常。结论 :骨髓原 (早 )幼细胞 Ki- 6 7指数在一定程度上反映了白血病细胞的增殖活性 ,Ag NORs反映了白血病细胞增殖分化不同步现象 。

Objective:To study the cell proliferation associated antigen Ki 67 expression and argyrophilic nucleolar organizer region (AgNOR) score in bone marrow cells of leukemia,and their clinical relevance.Methods:The Ki 67 and AgNORs were dtermined in 21 normal and 75 leukemic bone marrow cells by immunohistochemistrmy(ABC) and argyrophilic stain.Results:Ki 67 index were 2.5%(AML),12.2%(ALL),17.25%(CML),23.2%(control),significant difference were found among them;the AgNORs were significant higher in AML(3.60±0.63) and ALL(3.44±0.58) than in control group(1.90±0.40);pretreatment Ki 67 index of acute leukemia(AL) was found in significant relation with the posibility of complete remission(CR),when CR was achieved,the Ki 67 index and AgNORs were similar to the control.Conclusion:These data suggest that Ki 67 index may,to some extent,reflect the cellular kinetics of leukemia,whereas AgNORs may reflect the errors in cell proliferation and differentiation of leukemia,and both were related to stage and prognosis of the disease.