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目的探究急性淋巴细胞白血病(ALL)患儿p16蛋白及DNA水平的表达及意义。方法将64例小儿急性淋巴细胞白血病(ALL)作为研究组,60例健康体检幼儿作为对照组,采用SP免疫组化法检测p16蛋白表达水平,流式细胞术检测机体内白血病细胞DNA含量,对比分析两组的差异。结果对照组p16蛋白表达阳性率为100.00%(60/60),研究组p16蛋白表达阳性率为45.31%(29/64),组间对比,差异有统计学意义(P<0.05)。研究组中标危ALL(SR-ALL)p16蛋白阳性率为53.57%(15/28),高危ALL(HR-ALL)阳性率为27.78%(10/36),组间比较,差异显著(P<0.05)。研究组p16蛋白表达年龄、性别间比较,差异无统计学意义(P>0.05);而肝脾肿大﹑WBC及临床分型间差异有统计学意义(P<0.05)。对照组无异倍体检出,研究组异倍体检出率为51.56%(33/64),两者比较,差异有统计学差异(P<0.05)。p16蛋白表达阴性患儿DNA异倍体发生率为65.71%(23/35),p16阳性表达患儿异倍体发生率为34.48%(10/29),两者比较,差异有统计学意义(P<0.05)。结论 p16蛋白在急性淋巴细胞白血病患儿发病过程中起着重要作用,p16蛋白表达阴性者DNA异倍体的发生率高,与临床高危因素有关,p16蛋白缺失者可能与ALL发病、复发以及死亡有关。
Objective To investigate the expression and significance of p16 protein and DNA in children with acute lymphoblastic leukemia (ALL). Methods 64 children with acute lymphoblastic leukemia (ALL) as research group and 60 healthy children as control group, the expression of p16 protein was detected by SP immunohistochemical method, and the DNA content of leukemia cells was detected by flow cytometry Analyze the differences between the two groups. Results The positive rate of p16 protein in control group was 100.00% (60/60). The positive rate of p16 protein in study group was 45.31% (29/64). The difference between the two groups was statistically significant (P <0.05). The positive rate of p16 protein in the study group was 53.57% (15/28) and that in high-risk ALL (27.78%) was significantly higher than that in the study group (P < 0.05). There was no significant difference in the expression of p16 protein between study group and sex (P> 0.05), but there was significant difference between hepatomegaly and splenomegaly, WBC and clinical classification (P <0.05). There was no aneuploidy in the control group. The aneuploidy rate in the study group was 51.56% (33/64). There was significant difference between the two groups (P <0.05). The incidence of DNA aneuploidy in children with negative p16 protein expression was 65.71% (23/35), and the incidence of aneuploidy in children with p16 expression was 34.48% (10/29). There was significant difference between the two P <0.05). Conclusion The p16 protein plays an important role in the pathogenesis of acute lymphoblastic leukemia. The incidence of p16 protein is high in patients with aneuploidy, which is related to clinical risk factors. The loss of p16 protein may be associated with the onset, recurrence and death of ALL related.