急性白血病p53蛋白表达的临床意义

目的：检测p53蛋白在成人急性髓系白血病(AML)和急性淋巴细胞白血病(ALL)不同分组的表达率，分析p53蛋白阳性表达是否可以作为预测化疗耐药的指标。方法：急性白血病患者骨髓标本72例：初治组18例，完全缓解(CR)组38例，复发组16例。用流式细胞仪和单克隆抗体检测p53蛋白在骨髓标本中表达率。分析在不同分组之间表达率有无差异及阳性表达与诱导化疗CR率的关系。结果：1)p53蛋白总表达率为29．17％，初治组、CR组和复发组表达率分别为11．11％、21．05％和68．75％，复发组明显高于与初治组和CR组(P=0．0056，P=0．0085)，初治组和CR组表达无差别(P=0．37)。2)p53表达率在ALL55．6％)显著高于AML(20．37％)(P=0．01)。3)p53阳性组CR率(47．62％)显著低于阴性组CR率(74．51％)(P=0．028)。结论：p53表达率于复发组显著高于初治和CR组，ALL组显著高于AML组。P53蛋白高表达是对化疗耐药的指标之一。

Expression of p53 Protein in Acute Myeloid and Lymphoblastic Leukemia: Correlation with Induction Treatment Outcome

Objective: Assay the expression of p53 protein in acute myeloid leukemia( AML) and acute lymphoblastic leukemia( ALL). Estimate the positive expression of p53 protein if can use as an index of drug resistance. Methods: 72 cases acute myeloid and lymphoblastic leukemia inpatients were divided into three groups: new treatment group (18 cases), complete remission group (38cases) and relapse group (16 cases). Use flow cytomentry and monoclonal antibody assays the expression of p53 in 72 cases of acute leukemia, analysis the relation between positive expression rates and completely remission(CR) rates. Results: DThe rates of positive expression of p53 protein in groups of new treatment, CR and relapse were 11.11 % ,21. 05 % and 68. 75 %, respectively. 2) Expression of p53 protein between ALL and AML were 55. 6% and 20. 37%(P = 0. 01). 3. Rates of complete remission between positive and negative expression of p53 patients were 47. 62% and 74. 51 %. Conclusion:Positive expression of p53 protein was more distributed in relapse group than in new treatment and CR groups, and more distributed in ALL group than in AML group. Positive expression of p53 protein was significantly associated with a lower CR rate.