急性淋巴细胞白血病复发预测的研究

The experimental study on predicting the relapse of acute lymphoblastic leukemia

目的 :探讨急性淋巴细胞白血病 (ALL)的复发与P16蛋白缺失和bcl 2蛋白及血清可溶性白细胞介素 2受体 (sIL 2R)表达的关系。方法 :采用双抗体夹心酶联免疫吸附法 (ELISA)测定sIL 2R ,采用免疫组织化学方法测定P16蛋白、bcl 2蛋白的表达水平。结果 :在ALL中 ,P16蛋白缺失率、bcl 2蛋白阳性率及sIL 2R表达 ,复发组显著高于初诊组 (P <0 .0 1) ,初诊组显著高于完全缓解组 (CR组 ) (P <0 .0 1) ;初诊和复发ALL患者P16蛋白缺失率、bcl 2蛋白及sIL 2R表达与外周血白细胞总数 (r =0 .779,0 .886 ,0 .86 0 )、外周血幼稚细胞比值 (r =0 .82 1,0 .80 9,0 .813)和肝脾肿大呈正相关 (r =0 .84 6 ,0 .75 5 ,0 .84 0 ) (P <0 .0 1)。结论 :监测P16蛋白缺失、bcl 2蛋白及sIL 2R表达水平可预测ALL的复发。

Objective:To explore the relation between the relapse and the frequency of P16 protein deletson, the expression of bcl 2 protein and sIL 2R in acute lymphoblastic leukemia(ALL).Method:with ELISA, APAAP, we determined sIL 2R, bcl 2 protein and P16 protein.Result:Among ALL patients, the frequency of P16 protein inactivation and the levels of bcl 2 protein and sIL 2R, were the highest in the relapse group and the lowest in the CR group, P< 0.01 , were positivily correlation with the number of WBC(r= 0.779 , 0.886 , 0.860 )and the percentage of blast cell (r= 0.821 , 0.809 , 0.813 )and enlargement of liver and spleen (r=0.846 , 0.755, 0.840) in the relapsed and newly diagnosed group P< 0.01 .Conclusion:Monitor of inactivation of P16 protein and level of bcl 2 protein and sIL 2R could predict impending relapse of patients with ALL.