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目的：了解急性髓系白血病细胞H－rasP21表达与点突变的相关性，以及免疫组化法的临床实用价值。方法：用流式细胞术（FCM）分析67例初治急性髓系白血病（AML）H－rasp21表达；对所有P21阳性和部分P21阴性者作聚合酶链反应（PCR），观察H－ras15位密码子点突变。结果：67例AMLFCMP21阳性者45例（67．2％），P21阴性者22例（32．8％）。P21阳性45例中高表达者22例（48．9％），16例（72．7％）检出H－ras15位密码子点突变，11例（50％）完全缓解（CR）。10例P21阴性和23例P21＋低表达均无H－ras15位密码子点突变，CR率分别为77．2％和87．2％。结论：FCMP21高表达者常有H－ras15位密码子点突变，CR低，H－ras点突变与免疫组化P21＋高表达相关良好，提示AML转归不良。
Objective: To investigate the correlation between H-rasP21 expression and point mutations in acute myeloid leukemia cells and the clinical value of immunohistochemistry. Methods: Flow cytometry (FCM) was used to analyze the expression of H-rasp21 in 67 cases of newly diagnosed acute myeloid leukemia (AML). Polymerase chain reaction (PCR) was performed on all patients with P21 positive and partial P21 negative. Codon point mutations. Results: Forty-seven cases (67.2%) were positive for AMLFCMP21, and 22 cases (32.8%) were negative for P21. Twenty-two (48.9%) of the 45 patients with high expression of P21 were positive, and 16 (72.7%) patients had mutations in the H-ras15 codons, and 11 (50%) had complete remission (CR). There were no H-ras15 codon mutations in 10 cases of P21 negative and 23 cases of low expression of P21+, and the CR rates were 77.2% and 87.2%, respectively. Conclusion: High expression of FCMP21 often has H-ras15 codon mutations, low CR, H-ras point mutations and high expression of immunohistochemistry P21+, suggesting that AML outcome is poor.