bcl-2和bax基因在急性白血病细胞中的表达及其意义

THE EXPRESSION OF BCL-2 AND BAX GENES IN ACUTE LEUKEMIA AND THEIR SIGNIFICANCE

目的 :研究 bcl- 2和 bax基因在急性白血病 (AL)细胞中的表达及其与 AL 的分型、临床特征、疗效及预后因素的关系。方法 :采用免疫组化 SP法检测 5 4例初治 AL 骨髓细胞的 bcl- 2和bax基因蛋白的表达情况 ,分析其与 FAB分型、临床特征、疗效及预后因素的关系。结果 :AL 骨髓细胞中 bcl- 2基因的表达显著高于正常对照组 (P<0 .0 5 ) ,而 bax基因的表达低于正常对照 (P<0 .0 5 )。bcl- 2和 bax基因表达在急性髓系白血病 (AML)与急性淋巴细胞白血病 (AL L)无显著差异 ;在 AML的亚型中 ,bcl- 2在 M4 及 M5中的表达高于 M1 、M2 和 M3(P<0 .0 5 ) ;而 bax的表达在各亚型中无显著性差异。bcl- 2的表达与初诊时的白细胞数呈正相关 (r=0 .4 4 ,P<0 .0 5 ) ,与疗效呈负相关 (r=- 0 .4 0 ,P<0 .0 5 ) ;bax的表达与骨髓白血病细胞数呈负相关 (r=- 0 .34,P<0 .0 5 ) ,与髓外浸润呈负相关 (r=- 0 .4 5 ,P<0 .0 5 )。结论 :bcl- 2和 bax基因的紊乱是 AL 形成与发展的原因之一。这些细胞凋亡调控基因不仅参与了白血病的形成 ,还与白血病的某些临床特征、疗效及预后因素密切相关。

Objective:To study the expression of bcl 2 and bax genes in acute leukemia and their significance in the FAB classification,some clinic features,treatment outcome and prognostic factors of acute leukemia (AL).Methods:By using immunohistochemical staining method analysis,the expressions of bcl 2 and bax genes in 54 cases of untreated AL were detected,and the correlation of these genes with FAB classification,some clinic features,treatment outcome and prognostic factors of AL were also study.Results:Overexpressions of bcl 2 genes were found in AL ( P <0.05), the lower expression of bax gene was found in AL ( P <0.05). According to FAB classification, the expression of bcl 2 in acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL) had no significance. The expression of bcl 2 was higher in type M 4 and M 5 than type M 1, M 2 and M 3 ( P <0.05) . The expression of bax in various type had no significance ( P >0.05 ). The expression of bcl 2 genes was significantly correlated with the WBC number without treated ( r =0.44, P <0.05 ) and the treatment outcome ( r =-0.40, P <0.05 ) ; there was correlation of bax expression with the percentage of blast cells in bone marrow ( r =-0.39, P <0.05 ) and extramedullary infitration ( r =-0.45, P <0.05).Conclusions:Abnormal expressions of bcl 2 and bax genes in AL indicated that they play a pivotal role in pathogenesis and progression of AL.These apoptosis regulateding genes were still related to some clinic features,treatment outcome and prognostic factors of leukemia.