复发/难治性急性白血病bcl-2、p170的检测研究

THE INVESTIGATION OF THE EXPRESSION OF bcl-2 p170 IN RELAPSED OR REFRACTORY ACUTE LEUKEMIA

目的 :探讨 bcl-2、p170在复发 /难治性急性白血病中的表达及其与预后的关系。方法 :采用链亲和素—胶体金法和活细胞间接免疫荧光法分别检测了 73例急性白血病 (AL )患者的bcl-2、p170表达。结果 :不管在初治还是复发 /难治 AL患者中 bcl-2、p170的表达均与患者一般情况无关。在复发 /难治组中 bcl-2、p170的表达率明显高于初治组。在接受化疗的 AL 中 bcl-2 -组的 2 9例中有 2 3例达完全缓解 (CR) (CR率 79.3 % ) ,bcl-2 +组的 13例仅 2例 CR(CR率 15 .4% ) ,两组 CR率差异具有显著性 (P<0 .0 0 1) ,而 p170 +组 4例 ,2例 CR(CR率 5 0 .0 % ) ;p170 -组 3 8例 ,2 3例 CR(CR率 60 .5 % ) ,二者相比差异无统计学意义 (P>0 .0 5 )。bcl-2与 AL的阳性符合率 84.6% ,阴性符合率 79.3 %。结论 :bcl-2 +高表达的 AL其 CR率低 ,其过度表达是造成耐药的重要原因 ,是判断 AL的预后的一项敏感指标。

Objective:To investigated the relationship between the expression of bcl 2?p170 and clinical prognosis in relapsed or refractory acute leukemia.Mothods:73 cases of acute leukemia (AL) were detected for the expression of bcl 2?p170 by in situ hybridization with streptavidin gold (ISH SAG) and indirect immunofluorescence technique respectively.Results:There was not correlation between the expression of bcl 2?p170 and the general condition of AL,not only in untreated but also in relapsed or refractory AL.The expression rates of bcl 2?p170 in relapsed or refractory AL were significantly higher than those in the untreated AL.High bcl 2(≥20 %) and low CR rate was noted in 2/13 cases (15.4 %) while low bcl 2(<20 %) and high CR rate was domostrated in 23/29 cases ( 79.3 % ) , the difference did significantly differ ( P <0.01 ) . The CR rate of AL in p170 + ( 50.0 %) group did not statistically different than those in p170 - (60.5 %) group ( P >0.05).The positive coincident rate of bcl 2 with the prognosis of AL was 84.6 %,the negative coincident rate was 79.3 %.Conclusion:High the expression of bcl 2 was associated with low complete remission rate.Overexpression of bcl 2 was important causation which leads to drugresistance in AL.There was more sensitivity of bcl 2 in predicting the prognosis of AL.