为了研究抗凋亡基因生存素和bcl 2及促凋亡基因Fas和bax在急性髓系白血病 (AML)中的表达及其临床意义 ,采用RT PCR法分析生存素在 6 8例初治AML病人骨髓细胞中表达的阳性率 ,用流式细胞术检测Fas,bcl 2和bax在AML病人骨髓细胞中的表达和bcl 2 /bax比值。研究结果显示 :① 6 8例初治AML病人生存素mRNA阳性率为 70 .6 % (48/ 6 8) ,明显高于对照 (30 % ,6 / 2 0 ) (P <0 .0 0 5 ) ;②治疗前 ,AML病人骨髓细胞表达Fas和bcl 2明显高于对照 (P <0 .0 0 1) ,但bax表达与对照差异无显著性 (P >0 .0 5 ) ;③生存素阳性AML病人表达Fas明显低于生存素阴性AML病人 (P <0 .0 1) ,bcl 2明显高于生存素阴性AML病人 (P <0 .0 0 1) ,bax表达无差异 (P >0 .0 1) ;④生存素阳性AML病人的CR率明显低于阴性组 (31/ 4 8,6 4 .6 %vs 18/ 2 0 ,90 % ,P <0 .0 5 ) ;⑤生存素阳性AML病人CR组Fas和bcl 2较治疗前明显下降 (P <0 .0 0 1) ,bax变化无差异 (P >0 .0 5 ) ,而生存素阳性的NR组Fas较治疗前显著下降 (P <0 .0 0 1) ,bcl 2则上升 (P <0 .0 0 1) ,bax变化无差异 (P >0 .0 5 ) ,bcl 2 /bax比值NR组明显高于CR组 (P <0 .0 0 1)。结论 :①初治AML病人 70 .6 %表达生存素 ,生存素阳性者CR低 ;②生存素阳性AML病人Fas低于生存素阴 In order to investigate the expression and clinical significance of anti-apoptotic gene survivin, bcl-2 and pro-apoptotic genes Fas and bax in acute myeloid leukemia (AML), RT-PCR was used to analyze the expression of survivin in 68 untreated AML patients The positive rate of Bcl-2 / Bax expression in bone marrow cells was detected by flow cytometry. The results showed that: (1) The positive rate of survivin mRNA in 68 newly diagnosed AML patients was 70.6% (48/68), which was significantly higher than that of the control (30%, 6/20) (P <0.05) ); ② Before treatment, the expression of Fas and bcl-2 in bone marrow cells of AML patients was significantly higher than that of control (P <0.01), but there was no significant difference between bax expression and control (P> 0.05) The expression of Fas in positive AML patients was significantly lower than that in survivin negative AML patients (P <0.01), bcl 2 was significantly higher than that in survivin negative AML patients (P <0.01), but there was no difference in bax expression .0 1). ④ The CR rate of survivin-positive AML patients was significantly lower than that of the negative group (31/48, 64.4% vs 18/20, 90%, P <0.05) Fas and bcl-2 in CR patients were significantly lower than those before treatment in positive AML patients (P <0.01), but there was no difference in bax (P> 0.05), while Fas in survivin-positive NR patients was significantly lower than that before treatment (P0.01), bcl 2 (P0.01), bax no significant difference (P0.05), and the ratio of bcl 2 / bax in NR group was significantly higher than that in CR group P <0 0 0 1). Conclusion: (1) 70.6% of patients with newly diagnosed AML express survivin with low CR of survivin; (2) Fas of survivin-positive AML patients is lower than that of survivin