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目的探讨survivin在急性白血病中的表达、细胞中的定位及与临床疗效的关系,并从细胞水平说明survivin定位表达与化疗疗效的关系。方法应用免疫组织化学链霉亲和素、生物素、过氧化物酶复合物方法,检测62例急性白血病患儿和40例同期住院患儿(排除急性白血病)骨髓细胞survivin的表达,survivin在细胞中的定位。同时用SABC法检测不同浓度柔红霉素作用的Molt-4细胞中survivin定位表达的变化,用流式细胞术检测细胞凋亡率。结果在62例急性白血病患儿中,survivin蛋白表达阳性率为41.9%(26/62),明显高于非急性白血病骨髓5.0%(2/40)(χ2=16.66,P<0.01);survivin在胞浆中的表达为46.2%(12/26),在胞核中的表达为53.9%(14/26),差异无统计学意义(χ2=0.3077,P>0.05),但二者第19天缓解率差异有显著性(P<0.05),sur-vivin胞核表达阳性者缓解率高于胞浆阳性表达者。DNR处理的Molt-4细胞survivin表达降低,呈时间和剂量依赖性,而且survivin从胞浆移位到胞核,流式细胞术显示细胞凋亡率也呈剂量和时间依赖性。结论①survivin在儿童急性白血病中表达率为41.9%,提示其在儿童急性白血病发生、发展和预后中的意义;②survivin在胞浆和胞核的不同表达与临床化疗疗效有关,可作为判断预后的指标;③DNR可以降低白血病细胞中survivin表达,并使其从胞浆移位到胞核,诱导细胞凋亡。
Objective To investigate the expression of survivin in acute leukemia and the relationship between the expression of survivin and clinical efficacy. The relationship between the expression of survivin and the efficacy of chemotherapy was also demonstrated at the cellular level. Methods Immunohistochemical streptavidin, biotin and peroxidase complex method was used to detect the expression of survivin in 62 children with acute leukemia and 40 inpatients with acute leukemia (excluding acute leukemia). Survivin expression was detected in cells In the positioning. Meanwhile, the expression of survivin in Molt-4 cells treated with different concentrations of daunorubicin was detected by SABC method. The apoptosis rate was detected by flow cytometry. Results The positive rate of survivin protein was 41.9% (26/62) in 62 children with acute leukemia, which was significantly higher than that in non-acute leukemia (2/40) (χ2 = 16.66, P <0.01) The expression in cytoplasm was 46.2% (12/26) in the cytoplasm and 53.9% (14/26) in the nucleus. There was no significant difference between the two groups (χ2 = 0.3077, P> 0.05) The difference in remission rate was significant (P <0.05), and the remission rate of sur-vivin positive cells was higher than that in cytoplasm positive ones. The survivin expression in DNR-treated Molt-4 cells was decreased in a time and dose-dependent manner, and the survivin translocated from the cytoplasm to the nucleus. Flow cytometry also showed that the apoptosis rate was also dose-dependent and time-dependent. Conclusion ① The expression rate of survivin in children with acute leukemia is 41.9%, which indicates its significance in the occurrence, development and prognosis of childhood acute leukemia. ② The different expression of survivin in cytoplasm and nucleus is related to the curative effect of chemotherapy, which can be used as an index to judge prognosis ; ③DNR can reduce the expression of survivin in leukemia cells, and make it shift from the cytoplasm to the nucleus to induce apoptosis.