急性髓系白血病Bcl-2/Bax比值与细胞生长类型和耐药关系的研究

为了解白血病耐药与Bcl-2,Bax基因和细胞生长的关系,运用半固体培养,MTT药敏试验和免疫组织化学测定抗原表达的方法研究40例急性髓系白血病(AML)。结果:AML患者Bcl-2/Bax比值显著高于正常对照组,分别为12.21±8.05和0.75±0.05(P<0.001)。细胞集落生长组Bcl-2/Bax比值为(14.84±8.88)较无集落生长组(7.14±3.41)明显增高(P<0.05),耐药组和药物敏感组Bcl-2/Bax比值分别为14.32±8.99和7.50±5.04,有显著性差异(P<0.05)。Bcl-2/Bax高比值患者化疗反应差,缓解率明显低于低比值患者(P<0.05)。结论:Bcl-2、Bax异常表达是AML形成、发展和产生耐药的重要因素,检测Bcl-2/Bax比值对指导治疗,药物选择及判断预后有重要意义。

Study on the Relationship between the Bcl-2/Bax ratio and the Growth Types of Leukemic Cells and Drug Resistance in Acute Myelogenous Leukemia

To investigate the relationship between drug resistance of leukemic cells and Bcl-2.Bax genes and cell growth, the ratio of Bcl-2 to Bax (Bcl-2/Bax) in 40 patients with acute myelogenous leukemia (AMD were determined with the self-solid culture, MTT assay and analysis of antigen expression by im-munohistocbemical methods. The results showed that Bcl-2/Bax ratio in AML (12. 21 ?. 05) was signifi-cantly higher than that in normal control (0. 75?. 05) (P<0. 001),Bcl-2/Bax ratio in colony growth group (14. 84 ?. 88) was higher than that in no-growth group (7. 14?3. 41) (P<0. 05). The Bcl-2/Bax ratio in drug resistance group and drug sensitivity group was 14. 32 ?8. 99 and 7. 50 ?. 04 respectively, with the difference being significant (P<0. 05). The complete remission (CR) rates in high Bcl-2/Bax ratio group were obviously lower than in low ratio group and worse chemotherapeutic response was easily observed in the former group (P<0. 05). It was coucluded that the alteration of Bcl-2 and Bax might be an important factor in the pathogenesis and the development and drug resistance in AML. The assay of BCl-2/Bax ratio may have impact on patient management and choice of chemotherapeutic agents and also provide information of indepen-dent prognosis.