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目的探讨凋亡抑制蛋白XIAP,Survivin在儿童急性白血病(AL)中的表达及其临床意义。方法54例AL患儿,其中初诊未治26例,治疗后完全缓解(CR)23例,复发5例。应用免疫组织化学方法检测其骨髓细胞XIAP,Survivin蛋白表达。对照组为10例非恶性血液病患儿。结果(1)XIAP,Survivin蛋白在初诊未治AL患儿骨髓中表达水平均高于缓解期(P<0.05,0.008)和对照组(P<0.05,0.008),与复发组相比均无显著性差异(P>0.05,0.008)。XIAP在缓解期仍高于对照组(P<0.05),Survivin在缓解期和对照组相比无显著性差异(P>0.008)。(2)初诊未治AL患儿XIAP,Survivin蛋白表达在急性淋巴细胞白血病(ALL)和急性髓细胞白血病(AML)组比较无显著性差异(P>0.05)。(3)初诊未治AL患儿XIAP,Survivin蛋白表达显著正相关(r=0.923,P<0.001)。结论(1)儿童AL XIAP,Survivin蛋白高表达,提示二者可能通过抑制肿瘤细胞的凋亡参与了AL的发生发展,为儿童AL的治疗提供了新思路。(2)XIAP,Survivin蛋白表达可能与AL的临床分型无关,有希望成为AL的诊断性指标。(3)初诊未治AL患儿XIAP,Survivin蛋白表达显著正相关,提示XIAP,Survivin在儿童AL的发生与发展中可能互相影响。
Objective To investigate the expression and clinical significance of XIAP and Survivin in childhood acute leukemia (AL). Methods 54 cases of AL children, including 26 cases of newly diagnosed, complete remission (CR) after treatment in 23 cases, 5 cases of recurrence. Immunohistochemistry was used to detect the expression of XIAP and Survivin protein in bone marrow cells. The control group was 10 children with non-hematologic malignancies. Results (1) The expression of XIAP and Survivin protein in bone marrow of AL children without initial treatment was significantly higher than that in remission (P <0.05, 0.008) and control group (P <0.05, 0.008) Sex differences (P> 0.05, 0.008). The level of XIAP in remission group was still higher than that in control group (P <0.05). There was no significant difference in Survivin between remission group and control group (P> 0.008). (2) The expression of XIAP and Survivin in newly diagnosed AL children had no significant difference between acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) group (P> 0.05). (3) There was a significant positive correlation between XIAP and Survivin protein expression in newly diagnosed AL children (r = 0.923, P <0.001). Conclusions (1) The high expression of AL XIAP and Survivin in childhood suggests that both of them may participate in the occurrence and development of AL by inhibiting the apoptosis of tumor cells, providing a new idea for the treatment of AL in children. (2) XIAP, Survivin protein expression may not be related to the clinical classification of AL, hopefully become a diagnostic indicator of AL. (3) There was a significant positive correlation between XIAP and Survivin protein expression in newly diagnosed AL children, suggesting that XIAP and Survivin may influence each other in the occurrence and development of AL.