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目的 :分析和评估急性白血病 bcl- 2、bax、p170及 CD34 等耐药相关指标表达的临床价值。方法 :p170、CD34 检测采用活细胞间接免疫荧光法 ,bcl- 2、bax检测采用链亲和素—胶体金原位杂交法 (ISH- SAG)。结果 :急性白血病复发难治组的 bcl- 2、bcl- 2 / bax的阳性表达率 (76 .9% ,88.5 % )均显著高于缓解组 (4 4 .1%、2 0 .6 % )及初治组 (4 2 .0 %、5 9.0 % ) (P<0 .0 5 ) ,而 bax的阳性表达率在缓解组 (70 .6 % )显著高于复发难治组 (34.6 % ) (P<0 .0 5 ) ,CD34 的阳性表达在复发难治组 (2 3.1% )显著高于缓解组 (2 .9% ) (P<0 .0 5 ) ,而 p170的表达率在两组之间无显著性差异 (P>0 .0 5 )。疗效分析发现 bcl- 2、bcl- 2 / bax的表达与临床缓解密切相关 ,其阴性组的完全缓解率 (CR)显著高于阳性组 (P<0 .0 5 )。而 p170、CD34 及 bax三个指标均显示与 CR无关 (P>0 .0 5 )。线性相关分析发现 bcl- 2和 bax之间显著相关 (r=0 .33,P<0 .0 1) ,而 p170、CD34 与二者均无相关性。 bcl- 2及 bcl- 2 / bax的敏感性(76 .90 %、88.5 0 % )高于 p170、CD34 及 bax(4 6 .2 %、2 3.1%、34.6 % ) ,这些指标联合检测的敏感性为 92 .3%。结论 :bcl- 2及 bcl- 2 / bax的高表达预示着急性白血病预后不良 ,可作为预测急
Objective: To analyze and evaluate the clinical value of the expression of bcl-2, bax, p170 and CD34 in acute leukemia. Methods: Indirect immunofluorescence assay was used to detect p170 and CD34, bcl-2 and bax were detected by streptavidin-colloid gold in situ hybridization (ISH-SAG). Results: The positive expression rates of bcl-2 and bcl-2 / bax in patients with refractory leukemia (76.9%, 88.5%) were significantly higher than those in patients with remission (44.1%, 20.6% (P <0.05) (P <0.05), while the positive expression rate of bax in remission group (70.6%) was significantly higher than that in relapsed or refractory group (34.6%) (P <0.05). The positive expression of CD34 in refractory relapsed patients (21.3%) was significantly higher than that in relieved patients (2.9%) (P <0.05) There was no significant difference between groups (P> 0.05). Efficacy analysis showed that the expression of bcl-2 and bcl-2 / bax was closely related to clinical remission, and the complete remission rate (CR) of the negative group was significantly higher than that of the positive group (P <0.05). The three indexes of p170, CD34 and bax all showed no correlation with CR (P> 0.05). Linear correlation analysis showed that there was a significant correlation between bcl-2 and bax (r = 0.33, P <0.01), while there was no correlation between p170 and CD34. The sensitivity of bcl-2 and bcl-2 / bax (76.90%, 88.5%) was higher than that of p170, CD34 and bax (46.2%, 23.1%, 34.6% Sex is 92.3%. Conclusion: The high expression of bcl-2 and bcl-2 / bax predicts the poor prognosis of acute leukemia and may be used as a predictor of acute