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目的 :研究 bcl- 2和 bax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 SP法检测 5 4例初治 AL 骨髓细胞的 bcl- 2和bax基因蛋白的表达情况 ,分析其与 FAB分型、临床特征、疗效及预后因素的关系。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基因的表达低于正常对照 (P<0 .0 5 )。bcl- 2和 bax基因表达在急性髓系白血病 (AML)与急性淋巴细胞白血病 (AL L)无显著差异 ;在 AML的亚型中 ,bcl- 2在 M4 及 M5中的表达高于 M1 、M2 和 M3(P<0 .0 5 ) ;而 bax的表达在各亚型中无显著性差异。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 .34,P<0 .0 5 ) ,与髓外浸润呈负相关 (r=- 0 .4 5 ,P<0 .0 5 )。结论 :bcl- 2和 bax基因的紊乱是 AL 形成与发展的原因之一。这些细胞凋亡调控基因不仅参与了白血病的形成 ,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 and bax genes in acute leukemia (AL) cells and their relationship with the classification, clinical features, therapeutic effects and prognostic factors of AL. Methods: The expressions of bcl-2 and bax protein in 54 newly diagnosed AL bone marrow cells were detected by immunohistochemical SP method. The relationship between the expression of bcl-2 and bax gene and FAB typing, clinical features, therapeutic effect and prognosis were analyzed. Results: The expression of bcl-2 gene in AL bone marrow cells was significantly higher than that in the normal control group (P <0.05), while the expression of bax gene was lower than that in the normal control group (P <0.05). bcl-2 and bax gene expression in acute myeloid leukemia (AML) and acute lymphoblastic leukemia (AL L) no significant difference in the AML subtypes, bcl-2 in M4 and M5 expression higher than M1, M2 And M3 (P <0.05), while the expression of bax had no significant difference in each subtype. There was a positive correlation between the expression of bcl-2 and the number of white blood cells (r = 0.44, P <0.05), which was negatively correlated with the therapeutic effect (r = -0.04, P <0.05) ; The expression of bax was negatively correlated with the number of myeloid leukemia cells (r = - 0.34, P <0.05), and negatively correlated with extramedullary infiltration (r = - 0.45, P <0.05 ). Conclusion: The disorder of bcl-2 and bax genes is one of the reasons for the formation and development of AL. These apoptosis regulatory genes not only involved in the formation of leukemia, but also with some of the clinical features of leukemia, efficacy and prognostic factors are closely related.