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目的研究早幼粒细胞白血病(PML)蛋白在急性早幼粒细胞白血病(APL)不同阶段存在形式,探讨全反式维甲酸(ATRA)、砷剂、化疗药物对PML蛋白存在形式的影响。方法收集42例APL的骨髓细胞和白血病NB4、MR2细胞,采用1μmol/L三氧化二砷(As_2O_3)、1μmol/L四硫化四砷(As_4S_4)、1μmol/L ATRA、10 mg/L阿糖胞苷、1 mg/L高三尖杉酯碱处理,采用间接免疫荧光法,检测处理前后细胞PML荧光信号变化。结果 APL初发病例87.5%表现为小荧光信号(细胞核内密布满天星般荧光亮点,多于30个/细胞),完全缓解病例91.67%表现为大荧光信号(细胞核内有较大的荧光亮点,少于30个/细胞),复发病例中83.33%表现为小荧光信号;与未加药组相比,ARTA组、As_2O_3组、As_4S_4组能使初发患者APL细胞的PML蛋白表达由小荧光信号转变为大荧光信号,阿糖胞苷组、高三尖杉酯碱组则无明显影响;ARTA能使NB4细胞PML蛋白表达由小荧光信号转变为大荧光信号,而不能改变MR2细胞PML蛋白表达的小荧光信号,As2O3和As4S4能使NB4、MR2细胞PML蛋白表达由小荧光信号转变为大荧光信号。结论检测APL细胞PML蛋白存在形式对APL预后判断及合理药物选择具有实际应用价值。
Objective To study the existence of PML protein in different stages of acute promyelocytic leukemia (APL) and to investigate the effect of ATRA, arsenic and chemotherapeutic agents on the existence of PML protein. Methods 42 APL myeloblasts and leukemic NB4 and MR2 cells were collected and cultured with 1μmol / L As 2 O 3, 1μmol / L As 4 S 4, 1μmol / L ATRA, 10 mg / L cytarabine, mg / L homoharringtonine, using indirect immunofluorescence method to detect changes of PML fluorescence signal before and after treatment. Results 87.5% of the initial cases of APL showed small fluorescence signal (more than 30 astrocytes in the nucleus and more than 30 cells / cell), and 91.67% of cases showed complete remission with large fluorescence signal (larger fluorescent spots in the nucleus, Less than 30 cells / cell), 83.33% of the recurrence cases showed small fluorescence signal.Compared with the untreated group, the expression of PML protein in the APL cells of the newly diagnosed patients was significantly decreased from the small fluorescence signal Transfection into large fluorescence signal, cytarabine group and homoharringtonine group had no significant effect; ARTA can make PML protein expression of NB4 cells change from small fluorescence signal to large fluorescence signal, but can not change the PML protein expression of MR2 cells Small fluorescent signals, As2O3 and As4S4 can make NB4, MR2 cells PML protein expression from a small fluorescence signal into a large fluorescence signal. Conclusion Detecting the existence of PML protein in APL cells has practical value in judging APL prognosis and selecting reasonable drugs.