Bcl—2、Bcl—XL、Bax、Bak在急性白血病细胞中的表达及其临床意义

目的观察凋亡调节蛋白的表达与急性白血病化疗效果的关系。方法用免疫细胞化学法对36例急性白血病患者(初治敏感组11例，复发难治组25例)白血病细胞中凋亡词节蛋白Bcl-2、Bcl-XL、Bax、Bak的表达进行分析。结果抗凋亡蛋白Bcl-2、Bcl-XL的平均阳性细胞率复发难治组为(41.68±14.39)％和(35.96±9.95)％，初治敏感组为(15.64±8.51)％和(12.91±8.63)％，两组间差异有显著性意义(P＜0.01)。促凋亡蛋白Bax、Bak的平均阳性细胞率复发难治组为(25.28±15.49)％和(15.53±10.64)％，初治敏感组为(21.55±12.58)％和(13.23±8.36)％，两组间差异无显著性意义(P＞0.05)。Bcl-2、Bcl-XL、Bax、Bck对36例急性白血病缓解率影响的Logistic回归分析表明，Bcl-XL是其中降低急性白血病缓解率的最重要因素。结论Bc1-2、Bcl-xL在急性白血病MDR发生中起调节作用，并且Bcl-XL可能比Bcl-2更为更要。

Expression of Bcl-2, Bcl-XL, Bax and Bak in Acute LeukemiaCells and Its Clinical Significance

Purpose To explore the relationship between expression of apoptosis-modulating proteins and chemotherapeutic efficacy in acute leukemia. Methods Immunocytochemical method was used to detect the expression of Bcl-2、Bcl-XL、Bax and Bak in 36 cases of acute leukemia including previously untreated/drug-sensitive group and refractory/relapse group. Results The average positive cell rates of Bcl-2 and Bcl-XL in refractory/relapse group were (41.68 ± 14.39) % and (35.96 ± 9.95 ) %, while the rates in previously untreated/drug-sensitive group were (15.64 ± 8.51 )% and (12.91 ± 8.63 )%. Statistical analysis showed the average positive cell rates of Bcl-2 and Bcl-XL in refractory/relapse group were higher than those in previously untreated/drug-sensitive group (P ＜ 0.01 ). There was no significant difference in average positive cell rates of Bax and Bak between refractory/relapse group (25.28 ± 15.49) %, (15.53 ±10.64) % and previously untreated/drug-sensitive group (21.55 ± 12.58)%, (13.23 ± 8.36)%. The Logistic regression of expression of Bd-2 、Bcl-XL、Bax and Bak to complete remission rate (CR) of 36 cases of acute leukemia showed that Bcl-XL was the most risk factor in reducing the CR. Conclusions Bcl-2 and Bcl-XL might play important roles in multi-drug resistance of acute leukemia and Bcl-XL was more important than Bcl-2.