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目的研究抗凋亡基因ｂｃｌ－２在４６例急性白血病骨髓细胞中的表达及其与凋亡、细胞增殖、ＤＮＡ倍体及疗效间关系的临床意义。方法采用免疫流式细胞术。结果４６例急性白血病细胞均不等程度表达ｂｃｌ－２染色阳性率８．３％～４７．７％和凋亡细胞３．０％～２１％。ｂｃｌ－２高表达者１３例（≥２０％），低表达者３３例（＜２０％）。多数病例的ｂｃｌ－２表达与凋亡呈负相关，高ｂｃｌ－２低凋亡（＜１５％）１１例（８４．６％），低ｂｃｌ－２高凋亡（≥１５％）者１９例（５７．６％），两者均低１４例（４２．２％），两者均高２例。与ｂｃｌ－２低表达者比较，ｂｃｌ－２高表达者完全缓解率低（６／１３例，４６．１％比２９／３３例，８７．９％），ＤＮＡ异倍体者多（１１／１３例，８４．６％比８／３３例，２４．２％），且易复发（３／６例，５０％比２／２９例，６．８％）。结论由于ｂｃｌ－２表达的异质性，ｂｃｌ－２不是调控凋亡的唯一因素，但有临床预后意义，也可能在白血病发生上起作用
Objective To investigate the expression of anti-apoptotic gene bcl-2 in 46 acute leukemia myeloid cells and its relationship with apoptosis, cell proliferation, DNA ploidy and clinical efficacy. Methods using immune flow cytometry. Results The positive rate of bcl-2 staining was 8.3% to 47.7% and the apoptotic cells were 3.0% to 21%. There were 13 cases (≥20%) with high bcl-2 expression and 33 cases (<20%) with low expression. In most cases, bcl-2 expression was negatively correlated with apoptosis, with high bcl-2 low apoptosis (<15%) in 11 cases (84.6%), and low bcl-2 high apoptosis (≥15%) in 19 cases. (57.6%), both were 14 cases (42.2%) lower, both of which were 2 cases high. Compared with those with low expression of bcl-2, the complete response rate of patients with high bcl-2 expression was low (6/13 cases, 46.1% vs 29/33 cases, 87.9%), and DNA aneuploidy was much more (11/ 13 cases, 84.6% compared with 8/33 cases, 24.2%), and easy to relapse (3/6 cases, 50% than 2/29 cases, 6.8%). Conclusion Because of the heterogeneity of bcl-2 expression, bcl-2 is not the only factor regulating apoptosis, but it has clinical prognostic significance and may also play a role in the development of leukemia.