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目的通过检测抗凋亡蛋白XIAP和促凋亡蛋白Smac在ALL患儿中的表达,探讨XIAP、Smac在儿童ALL中的临床意义。方法 92例ALL患儿,其中初治组46例,缓解组28例,复发组18例。对照组为25例骨髓像正常的非恶性血液病患儿。应用SP-免疫组织化学方法检测初治组、缓解组、复发组及对照组骨髓抗凋亡蛋白XIAP、促凋亡蛋白Smac表达情况。应用SPSS 11.5软件进行统计学分析。结果 1.XIAP、Smac在初治ALL患儿骨髓中表达水平均高于缓解组(P<0.05,P<0.008)和对照组(P<0.05,P<0.008),与复发组比较差异均无统计学意义(Pa>0.05)。2.初治ALL患儿骨髓XIAP低表达(XIAPlow)者完全缓解率明显高于XIAP高表达(XIAPhigh)患儿(P<0.05);Smac表达阴性(Smac-)患儿完全缓解率明显高于Smac表达阳性(Smac+)患儿,差异有统计学意义(P<0.05)。结论 XIAPhigh、Smac+在ALL的发病中可能发挥着重要作用,XIAPhigh、Smac+可能为ALL患儿预后不良的因素之一。
Objective To investigate the clinical significance of XIAP and Smac in childhood ALL by detecting the expression of anti-apoptotic protein XIAP and pro-apoptotic protein Smac in children with ALL. Methods 92 cases of ALL children, including 46 cases of initial treatment group, 28 cases of remission group, 18 cases of recurrence group. The control group was 25 children with normal bone marrow non-hematologic malignancies. SP-immunohistochemistry was used to detect the expression of bone marrow anti-apoptotic protein XIAP and proapoptotic protein Smac in newly diagnosed, remissioned, recurrent and control groups. SPSS 11.5 software was used for statistical analysis. The expression level of XIAP and Smac in the bone marrow of the newly diagnosed ALL children were significantly higher than that of the remission group (P <0.05, P <0.008) and the control group (P <0.05, P <0.008) Statistical significance (Pa> 0.05). The complete remission rate of XIAPlow in children with ALL was significantly higher than that in XIAPhigh children (P <0.05); the complete remission rate in Smac-negative children was significantly higher than that in XIAPhigh children Smac positive (Smac +) children, the difference was statistically significant (P <0.05). Conclusions XIAPhigh and Smac + may play an important role in the pathogenesis of ALL. XIAPhigh and Smac + may be one of the factors of poor prognosis in children with ALL.