小儿急性淋巴细胞白血病p16蛋白表达的临床研究

EXPRESSION OF p16 CONTENT IN ACUTE LYMPHOBLASTIC LEUKEMIA OF CHILDREN

探讨p16蛋白表达及DNA含量在小儿急性淋巴细胞白血病 (ALL)中的临床意义。应用S P免疫组化法检测 3 1例小儿ALL白血病细胞的p16蛋白表达水平 ,流式细胞术检测白血病细胞DNA含量。结果 ,3 1例ALL的p16蛋白表达缺失率为5 4 8% ( 17 3 1) ,p16蛋白缺失与高白细胞数 ( >2 5× 10 9 L)、肝脾肿大等高危临床特征显著相关 ;高危型ALL的p16基因缺失率 ( 70 5 % )远高于标危型ALL( 3 5 7% ) ,两组差异有显著性 (P <0 0 1)。小儿ALL异倍体发生率为 3 8 7% ,p16蛋白表达阴性者17例中DNA异倍体 9例 ( 9 17) ,p16蛋白表达阳性者中异倍体 4例 ( 4 14 ) ,比较差异无显著性 ( χ2 =1 10 6,P >0 0 5 )。结果表明 :p16蛋白失活在小儿ALL的发病过程中起重要作用 ,p16蛋白表达阴性者DNA异倍体的发生率高 ,与临床高危因素有关 。

Objective: To research the expression of p16 and DNA content of chil dr en with acute lymphoblastic leukemia(ALL) and its clinical significance. Method: Thirty one samples of ALL were studied by the methods of S P immuno chistoc hemical to determine the expression of p16 protein. Flow cytometry was used to d etermine DNA content of the leukemia cells. Results: The nagative expression rat e of p16 protein in childhood ALL patients was 54 8%. The high risk features are correlation with deletion of p16 protein expression. The negative expressio n rate of p16 in high risk group of ALL was significantly higher than in standar d risk group of ALL ( P <0 01). The DNA aneuploid rate in childhood ALL pat ients was 38 7%. The DNA aneuploid rate of ALL was found in 9 of 17 samples in deletion of p16 protein and in 4 of 13 samples in positive expression rate of p1 6, respectively ( P >0 05). Conclusion: Negative expression of p16 protein m ight imply the important role in the genesis of ALL. The levels of p16 protein e xpression show correlation with such factors as the high risk features and the DNA aneuploid rates. It may serve as one of indicators to predict the prognosis of patients.