XIAP及其相关因子1在急性淋巴细胞白血病中表达意义

目的：探讨X染色体连锁凋亡抑制蛋白（XIAP）及其相关因子（XAF1）在急性淋巴细胞白血病（ALL）中的表达及其临床意义,并评估其在临床治疗及预后中的价值。方法：采用病例对照研究,应用实时荧光定量聚合酶链反应（RQ-PCR）检测85例ALL患者骨髓标本中XIAP及XAF1的mRNA表达水平。结果：XIAP mRNA表达水平初诊ALL组高于CR组和对照组（P〈0.05）,而低于复发组（P〈0.05）,CR组表达水平高于对照组（P〈0.05）;而XAF1在ALL时呈低表达或不表达,CR组表达高于ALL其它组（P〈0.05）,与对照组差异无统计学意义（P〉0.05）。XIAP及XAF1二基因表达水平在T系ALL与B系ALL,成人与儿童,男女性别之间表达水平差异无统计学意义（P〉0.05）。XIAP/XAF1比值在ALL患者中初诊组和复发组明显高于对照组和缓解组（P〈0.05）,缓解组高于对照组（P〈0.05）。结论：ALL患者XIAP基因高表达,而XAF1呈现低表达或不表达,提示XIAP可能通过抑制白血病细胞凋亡参与了ALL的发生发展,并与预后不良及治疗反应相关。ALL中XIAP与XAF1表达水平的不平衡,可能是ALL预后不良及复发的一项重要因素之一。抑制XIAP及上调XAF1基因来治疗ALL,将为ALL的基因治疗提供新思路。

Expression and clinical significance of XIAP and XIAP associated factor 1 in acute lymphocytic leukemia

Objective：To investigate the expression and clinical significance of X-chromosome-linked inhibitor of apoptosis protein（XIAP）and XIAP associated factor1（XAF1）in acute lymphocytic leukemia（ALL）,and to assess the value of XIAP and XAF1 in clinical therapeutic efficiency and prognosis.Methods： Using case control study,the expression of XIAP and XAF1 mRNA was detected by real time fluorescence quantitative polymerase chain reaction（RQ-PCR）in 85 ALL patients＇ bone marrow samples.Results： The expression level of XIAP mRNA in newly diagnosed ALL group was significantly higher than that in complete remission（CR） group and control group（P0.05）,while lower than the relapse group（P0.05）,and CR group was higher than control group（P0.05）.The expression level of XAF1 in ALL was low or no expression,the CR group was higher than other groups in ALL（P0.05）,which compared with control group had no statistic significance（P0.05）.There was no statistical significance（P0.05）between T-ALL and B-ALL,adult and children ALL,male and female in the level of XIAP and XAF1 expression.The mRNA ratio of XIAP/XAF1 was significantly higher in newly diagnosed and relapse ALL group than in control group and CR group（P0.05）,and CR group was higher than control group（P0.05）.Conclusion： High expression of XIAP gene,while low or no expression of XAF1 gene in ALL patients indicates that XIAP may involve in the occurrence and development of ALL through inhibiting apoptosis of leukemia cells,and related to the poor prognosis and response of treatment.The imbalance in XIAP/XAF1 mRNA expression levels might correlate to overall survival and relapse.Inhibiting the expression of XIAP and increasing the expression of XAF1 will provide a novel strategy for gene therapy of ALL.