急性髓系白血病的bcl-2基因表达及其临床意义

EXPRESSION OF bcl-2 GENE IN ACUTE MYELOID LEUKEMIA CELLS AND THE CLINICALSIGNIFICANCE

目的 :探讨 bcl- 2基因在急性髓系白血病 (AML)中的表达与预后的关系。方法 :应用链亲和素 -胶体金原位杂交 (ISH- SAG)法检测 5 7例 AML 患者单个核细胞的 bcl- 2基因表达水平。结果 :5 7例 AML 患者不同程度表达 bcl- 2基因 ,范围从 0～ 98% ,其中初治组的阳性率为 4 6 .2 %(2 4 / 5 2 ) ,缓解组的阳性率为 4 0 .7% (11/ 2 7) ,难治复发组的阳性率为 10 0 % (15 / 15 ) ;难治复发组与初治组及缓解组之间差异均具有显著性 (P<0 .0 1) ,AML 各亚型之间表达无显著性差异 (P>0 .0 5 ) ;疗效分析发现 bcl- 2基因表达与临床缓解密切相关 ,阴性组缓解率 (76 .2 % )显著高于阳性组 (4 2 .1% ) (P<0 .0 5 )。结论 :bcl- 2基因过度表达对 AML 的预后有重要关系 ,可作为判断预后和合理制定治疗方案的重要依据。

Objective:To study the clinical significance on the expression of bcl 2 gene in acute myeloid leukemia cells.Methods:Expression of bcl 2 gene was detected in mononuclear cell of bone marrow from 57 patients with in situ hybridization with streptavidin gold (ISH SAG).Results:There were different expressions in 57 patients.The scope is 0～98 %,the positive rate was 46.2 % in primary group ; 40.7 % in complete remission ( CR ) group ; 100 % in relapsed or refractory group . The expression was significantly higher in the relapsed or refractory group than that in the primarygroup and CR group ( P <0.01 ) . No relationship was observed between the expression of bcl 2 gene and FAB type ( P >0.05 ) . It was found that the expression of bcl 2 gene was related to the clinical remission.CR rate was 42.1 % in bcl 2 positive cases and 76.2 % in bcl 2 negative group ( P <0.05).Conclusion:The overexpression of bcl 2 gene were relevant to the poor prognosis.The expression of bcl 2 gene was detected to explore its predictive values,which might be helpful to guide the using of drugs in clinic.