凋亡调控基因在婴幼儿白血病表达及与预后关系

目的 　检测婴幼儿白血病患儿凋亡调控基因bcl- 2表达水平 ,探讨其在婴幼儿白血病发病机制中的作用及对预后的估计。方法 　单克隆抗体荧光流式免疫学方法。结果 　① 2 0例白血病细胞均不同程度表达bcl - 2 ,阳性细胞率为 1 2 5%～6 0 4 %。②bcl- 2高表达患儿具有明显肝脾 /淋巴结肿大 ,有较高比例的骨骼疼痛 ,以及唾液腺、皮肤浸润。③bcl- 2蛋白高表达的患儿初诊时外周血白细胞 (WBC)明显增高 ( >50× 1 0 9/l) ,血小板下降较明显 ( <50× 1 0 9/l) ,脑脊液 (CSF)检查确诊为中枢神经系统白血病 (CNSL)占 1 5例。④bcl- 2高表达的患儿 ,临床缓解率明显下降。结论 　bcl- 2蛋白高表达者 ,临床症状重 ,化疗效果差 ,预后不良。与临床高危因素一致。说明bcl- 2基因蛋白参与细胞凋亡的调控 ,具有临床意义。

Expression of apoptosis gene protein and clinical significance in infant with acute leukemia

Objective To measure bcl-2 proteins expression and explore the clinical significance in infant with acute leukemia (AL). Methods bcl-2 proteins was detected with a specific monoclonal antibody and flow cytometry. Result (1) There were some difference for the expression of bcl-2 in 20 infant AL patients. The bcl-2 proteins positive were 12.5%～60.4%. (2) High bcl-2 levels(>21%) were associated with liver, spleen, lymphnode swell, high white blood cell (WBC) count and low platelet (PLT) count(<0.05). (3)the complete remission rate in those patients with high bcl-2 levels was lower. Conclusion bcl-2 protein displays a overexpression in infant AL. which are correlated with the prognosis and therapy reaction.