生存素,Fas,bcl-2和bax在急性髓系白血病病人骨髓细胞中的表达及其临床意义

Expression of Survivin,Fas,bcl-2 and bax in Bone Marrow Cells from Acute Myeloid Leukemia Patients and Its Clinical Significance

为了研究抗凋亡基因生存素和bcl 2及促凋亡基因Fas和bax在急性髓系白血病 (AML)中的表达及其临床意义 ,采用RT PCR法分析生存素在 6 8例初治AML病人骨髓细胞中表达的阳性率 ,用流式细胞术检测Fas,bcl 2和bax在AML病人骨髓细胞中的表达和bcl 2 /bax比值。研究结果显示 :① 6 8例初治AML病人生存素mRNA阳性率为 70 .6 % (48/ 6 8) ,明显高于对照 (30 % ,6 / 2 0 ) (P <0 .0 0 5 ) ;②治疗前 ,AML病人骨髓细胞表达Fas和bcl 2明显高于对照 (P <0 .0 0 1) ,但bax表达与对照差异无显著性 (P >0 .0 5 ) ;③生存素阳性AML病人表达Fas明显低于生存素阴性AML病人 (P <0 .0 1) ,bcl 2明显高于生存素阴性AML病人 (P <0 .0 0 1) ,bax表达无差异 (P >0 .0 1) ;④生存素阳性AML病人的CR率明显低于阴性组 (31/ 4 8,6 4 .6 %vs 18/ 2 0 ,90 % ,P <0 .0 5 ) ;⑤生存素阳性AML病人CR组Fas和bcl 2较治疗前明显下降 (P <0 .0 0 1) ,bax变化无差异 (P >0 .0 5 ) ,而生存素阳性的NR组Fas较治疗前显著下降 (P <0 .0 0 1) ,bcl 2则上升 (P <0 .0 0 1) ,bax变化无差异 (P >0 .0 5 ) ,bcl 2 /bax比值NR组明显高于CR组 (P <0 .0 0 1)。结论 :①初治AML病人 70 .6 %表达生存素 ,生存素阳性者CR低 ;

To study the clinical significance of the expression of antiapoptosis gene, survivin and bcl 2, and proapoptosis gene, Fas and bax, in acute myeloid leukemia (AML), RT PCR was used to examine the expression of survivin and flow cytometry (FCM) to detect the expression of Fas, bcl 2, bax and bcl 2/bax ratio in 68 cases of AML. The results demonstrated that: (1) The positivity of survivin mRNA expression was significantly higher in AML compared to control (70.6% vs 30%, P<0.05). (2) The expression of Fas and bcl 2 in AML before treatment was significantly higher than that in control (P<0.001), but the bax expression did not (P>0.05). (3) The survivin positive AML cases showed a significantly lower Fas and higher bcl 2 expression in comparison with survivin negative ones (P<0.01 and P<0.001, respectively) , but the bax did not (P>0.01). (4) Survivin positive AML cases had a lower CR rate as compared with survivin negative cases (64.6% vs 90%, P<0.05). (5) The survivin positive CR cases showed a decreased expression of Fas and bcl 2 after treatment in comparison with pretreatment expression (P<0.001 ), but the bax expression remained unchanged before and after therapy. The survivin positive NR cases showed a significantly decreased Fas and increased bcl 2 expression as compared with pretreatment expression (P<0.001). bcl 2/bax ratio was also significantly higher in NR cases. In conclusion: 70.6% AML cases showed positive for survivin expression with a lower CR rate, the survivin positive AML showed a low Fas with high bcl 2 expression and bcl 2/bax ratio as compared to the survivin negative cases.