白血病bcl-2、P170、CD_(34)表达的临床意义和相关性

目的：探讨白血病ｂｃｌ ２、Ｐ１７０、ＣＤ３４表达的临床意义和相关性，评估其临床预测价值。方法：用ＡＢＣ免疫细胞化学方法检测７７例急性白血病、２３例慢性粒细胞白血病（ＣＭＬ）ｂｃｌ ２、Ｐ１７０、ＣＤ３４的表达。结果：复发／难治的急性白血病ｂｃｌ ２、Ｐ１７０、ＣＤ３４的表达高于初治者。ｂｃｌ ２、Ｐ１７０、ＣＤ３４高表达的急性白血病完全缓解率低，早期复发率高，预后差，ｂｃｌ ２与急性白血病预后的阳性符合率为９０９％，较Ｐ１７０、ＣＤ３４略高。ＣＤ３４在ＣＭＬ慢性期和加速期／急变期的表达有显著性差异。ｂｃｌ ２与Ｐ１７０的表达呈轻度正相关（ｒ＝０３８６，Ｐ＜０００１）。结论：ｂｃｌ ２、Ｐ１７０、ＣＤ３４为急性白血病疗效、预后的指标，ｂｃｌ ２的预测敏感性较高，三者联合检测的预测价值更高。ＣＤ３４为ＣＭＬ病程变化的标志。不同ＭＤＲ机制可能存在联系。

Study on the clinical significance of the expression of bcl2,P170,CD34 in leukemia and their correlation

Objective: To study and assess the clinical significance of the expression of bcl2,P170,CD34 in leukemia, and their correlation. Methods: ABC immunocytochemistry was used in detection of the expression of bcl2,P170,CD34 in leukemic cells from 77 cases acute leukemia and 23 cases chronic myeloid leukemia patients. Results: The expression rates of bcl2,P170,CD34 in relapsed or refractory acute leukemia were significantly higher than those in the untreated acute leukemia. The complete remission rates were significantly lower in the patients with overexpression than in those with low/nonexpression of one of the detected markers,bcl2,P170 and CD34. The expression of CD34in CML accelerative or excess blast phase was higher than that of in chronic phase. It was found the positive coincidence rates were 90.9% for overexpression of bcl2, which was a little higher than that of P170 or CD34It was also suggested there was slightly positive correlation between the expression rates of bcl2 and P170 (r=0.386, MDRP<0001). Conclusion: There is more sensitive predictive value of bcl2 in these three markers. The combined drtection of bcl2, P170and CD34 may improve the pedictive value of each. It was also suggested that CD34could be a poor indicator in the course of CML. There may be some relation between the different MDR mechanisms.