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目的探讨ＭＤＳ患者ｒａｓ－ｐ２１的表达及其与急性白血病转化的关系。方法应用ｒａｓ－ｐ２１单克隆抗体免疫细胞化学分析法。结果２５例骨髓增生异常综合征（ＭＤＳ）患者中有８例ｐ２１阳性，占３２．０％。其中５例ｐ２１阳性的ＭＤＳ患者发生急性白血病（ＡＭＬ）转化，中位数存活期为２１个月。１７例ｐ２１阴性的ＭＤＳ患者除了３例未治疗，１例ＡＭＬ转化，ｐ２１转阳性外，其余１３例在１２～６０个月内均未发现ＡＭＬ转化，且病情较稳定。结论ｒａｓ－ｐ２１的表达与ＭＤＳ的白血病转化有一定相关性，该指标有望成为监测ＭＤＳ患者ｒａｓ基因激活状态及白血病发生的一个生物学指标。
Objective To investigate the expression of ras-p21 in patients with MDS and its relationship with the transformation of acute leukemia. Methods ras-p21 monoclonal antibody immunocytochemistry analysis. Results Among the 25 patients with myelodysplastic syndrome (MDS), 8 were positive for p21, accounting for 32.0%. Five of the 21 patients with p21-positive MDS developed acute leukemia (AML) with a median survival of 21 months. Among the 17 patients with p21-negative MDS, 13 patients were untreated, 1 had AML transformed, and 21 were positive for p21. The other 13 patients did not find AML transformation within 12 to 60 months and the disease was stable. Conclusion The expression of ras-p21 may be related to the leukemic transformation of MDS. This index is expected to become a biological indicator to monitor the activation status of ras gene and the occurrence of leukemia in MDS patients.