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目的 观察凋亡调控基因bcl x和bcl 2在急性白血病 (AL)患者中的表达 ,探索AL的病理和化疗反应的分子机制。方法 应用半定量逆转录 聚合酶链反应 (RT PCR)技术检测bcl x(bcl xL、bcl xS)和bcl 2在 34例AL患者中mRNA水平的表达。结果 抑凋亡基因bcl xL 和bcl 2在AL细胞中的表达比在完全缓解和正常对照者骨髓细胞中的表达明显增高 (P <0 0 1) ,同时在复发患者AL细胞中的表达水平分别是初治患者的 1 8倍和 1 9倍 (P <0 0 1)。bcl xL 和bcl 2的表达以及bcl xL 和bcl xS 的表达均呈正相关 (P <0 0 1) ,但个体间有较大差异。未发现bcl xS 表达水平与AL的复发和疗效有关 ;治疗无效患者bcl xL 和bcl 2的表达比治疗有效者高 (P <0 0 1) ,bcl xL、bcl 2和此两基因同时高表达的患者临床治疗无效率分别为 80 0 %、91 7%和10 0 0 %。结论 AL的发病可能与抑凋亡基因bcl xL 和bcl 2的高表达有关 ;bcl xL 或bcl 2的高表达可以降低AL的化疗敏感性 ,而且是AL复发的高危因素
Objective To observe the expression of apoptosis-regulating genes bcl x and bcl 2 in patients with acute leukemia (AL) and explore the molecular mechanism of AL pathology and chemotherapy response. Methods Semi-quantitative reverse transcription polymerase chain reaction (RT PCR) was used to detect the mRNA expression of bcl x (bcl xL, bcl xS) and bcl 2 in 34 AL patients. Results The expression of anti-apoptosis genes bcl xL and bcl 2 in AL cells was significantly higher than that in complete remission and normal control bone marrow cells (P < 0 01), and the expression levels of ALB cells in relapsed patients were also different. It was 1 8 times and 1 9 times of the untreated patients (P < 0 01). The expression of bcl xL and bcl 2 and the expression of bcl xL and bcl xS were positively correlated (P < 0 01), but there were significant differences among individuals. The expression level of bclxS was not found to correlate with the recurrence and efficacy of AL; the expression of bcl xL and bcl 2 in patients with no treatment was higher than that in patients with effective treatment (P < 0 01), and bcl xL, bcl 2 and both genes were highly expressed simultaneously. The inefficiency of clinical treatment of patients was 80 %, 91 % and 100 %, respectively. Conclusion The pathogenesis of AL may be related to the high expression of bcl xL and bcl 2 genes. High expression of bcl xL or bcl 2 may reduce the chemosensitivity of AL and is a risk factor for AL recurrence.