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目的 研究bcl 2、Bax、Fas/Apo 1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 采用免疫组化方法检测 5 4例初治AL骨髓细胞bcl 2、Bax、Fas/Apo 1蛋白表达情况。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、Fas/Apo 1基因的表达显著低于正常对照组(P <0 .0 5 )。bcl 2、Bax、Fas/Apo 1基因表达在急性髓系白血病 (AML)与急性淋巴细胞白血病 (ALL)无显著差异 ;在AML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及Fas/Apo 1的表达在各亚型中无显著性差异 (P >0 .0 5 )。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 .39,P <0 .0 5 ) ,与髓外浸润呈负相关 (r =- 0 .4 5 ,P <0 .0 5 ) ,急性淋巴细胞白血病中Fas/Apo 1的表达与疗效呈正相关 (r =0 .34,P <0 .0 5 ) ,与骨髓原始细胞数呈负相关 (r =- 0 .71,P <0 .0 5 )。结论 bcl 2、Bax、Fas/Apo 1基因的紊乱可能在AL的发病中起着重要作用 ,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, Bax and Fas / Apo 1 genes in acute leukemia (AL) and their relationship with the classification, clinical features, therapeutic effects and prognosis of AL. Methods Immunohistochemistry was used to detect the expression of bcl-2, Bax and Fas / Apo 1 protein in 54 newly diagnosed AL bone marrow cells. Results The expression of bcl 2 gene in AL bone marrow cells was significantly higher than that in normal control group (P <0.05), while the expression of Bax and Fas / Apo 1 gene was significantly lower than that in normal control group (P <0.05). The expression of bcl 2, Bax and Fas / Apo 1 gene in acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) showed no significant difference. In AML subtype, the expression of bcl 2 in M4 and M5 was higher than that in M1, M2 and M3 (P <0.05). However, there was no significant difference in the expression of Bax and Fas / Apo 1 in all subtypes (P> 0.05). There was a positive correlation between the expression of bcl-2 and the number of white blood cells at the initial diagnosis (r = 0.44, P <0.05), but negatively correlated with the curative effect (r = - 0.40, P <0.05) The expression of Bax was negatively correlated with the number of myeloid leukemia cells (r = - 0.39, P <0.05), and negatively correlated with extramedullary infiltration (r = - 0.45, P <0.05) , The expression of Fas / Apo 1 in acute lymphoblastic leukemia was positively correlated with the curative effect (r = 0.34, P <0.05), and negatively correlated with the number of primitive myeloid cells (r = - 0.71, P <0 .0 5). Conclusion The disorder of bcl 2, Bax, Fas / Apo 1 gene may play an important role in the pathogenesis of AL. It is also closely related to some clinical features, curative effects and prognosis of leukemia.