急性白血病细胞bcl-2、Bax和Fas/Apo-1基因表达的研究

The Studies of the Expression of bcl-2,Bax and Fas/Apo-1 genes in Acute Leukemia

目的 研究bcl 2、Bax、Fas/Apo 1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 采用免疫组化方法检测 5 4例初治AL骨髓细胞bcl 2、Bax、Fas/Apo 1蛋白表达情况。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、Fas/Apo 1基因的表达显著低于正常对照组(P <0 .0 5 )。bcl 2、Bax、Fas/Apo 1基因表达在急性髓系白血病 (AML)与急性淋巴细胞白血病 (ALL)无显著差异 ;在AML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及Fas/Apo 1的表达在各亚型中无显著性差异 (P >0 .0 5 )。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 .39,P <0 .0 5 ) ,与髓外浸润呈负相关 (r =- 0 .4 5 ,P <0 .0 5 ) ,急性淋巴细胞白血病中Fas/Apo 1的表达与疗效呈正相关 (r =0 .34,P <0 .0 5 ) ,与骨髓原始细胞数呈负相关 (r =- 0 .71,P <0 .0 5 )。结论 bcl 2、Bax、Fas/Apo 1基因的紊乱可能在AL的发病中起着重要作用 ,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, Bax, Fas/Apo-1 genes in acute leukemia and their significance in the FAB classification, some clinical features, treatment outcome and prognostic factors of acute leukemia(AL). Methods By using immunohistochemical staining method analysis, the expressions of bcl-2, Bax、Fas/Apo-1 genes in 54 cases of untreated AL were detected.Results Overexpressions of bcl-2 genes were found in AL( P <0.05), low expressions of Bax and Fas/Apo-1 gene( P <0.05). The expression of bcl-2, Bax, Fas/Apo-1 in acute myeloid leukemia (AML) and acute lymphoid leukemia (ALL) had no significance. According to FAB classification,The expression of bcl-2 was higher in type M4 and M5 than M1, M2 and M3 ( P <0.05). The expression of bcl-2 gene was positively correlated with the WBC number( r =0.44, P <0.05) and was negatively correlated with the treatment outcome ( r =-0.40, P <0.05), and there was negatively correlation of Bax expression with the percentage of blast cells in bone marrow( r =-0.39, P <0.05)and extramedullary infiltration of Bax ( r =-0.45, P <0.05). The expression of Bax, Fas/Apo-1 in various types had no significance( P >0.05), there was positively correlation of Fas/Apo-1 expression with the treatment outcome ( r =0.34, P <0.05) and negatively percentage of blast cells in bone marrow ( r =-0.71, P <0.05) . Conclusion Abnormal expressions of bcl-2, Bax and Fas/Apo-1 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 clinical features, treatment outcome and prognostic factors of leukemia.