急性白血病患儿骨髓细胞环氧合酶-2和survivin表达及其意义

目的探讨环氧合酶-2(COX-2)和survivin蛋白在儿童急性白血病(AL)中的表达及意义。方法应用免疫组织化学链霉亲和素-生物素-过氧化物酶(SABC)法检测2006年6～11月收治42例AL患儿骨髓细胞中COX-2和survivin的表达,对照组为10例非恶性血液病且骨髓正常儿童。结果AL患儿COX-2和survivin表达阳性率分别为52.4%和45.2%,与对照组比较差异有显著性(Pa<0.05)。其中32例急性淋巴细胞白血病(ALL)COX-2和survivin的表达阳性率分别为46.9%和40.6%,与对照组比较差异有显著性(Pa<0.05)。ALL高危组和中低危组COX-2阳性表达率分别为54.5%和42.8%,二组比较差异无统计学意义(Pa>0.05)。AL42例COX-2与survivin表达均为阳性16例,均为阴性17例,COX-2和survivin蛋白表达呈正相关(r=0.579P<0.001)。COX-2阴性组初次完全缓解率高于阳性组(93.3%和66.7%),差异有显著性(P<0.05)。结论1.COX-2蛋白在儿童AL中表达增高;2.COX-2与抗凋亡因子survivin共同参与AL发展,二者可能起协同作用;3.COX-2高表达可能与儿童AL预后有关。

Expression of Cyclooxygenase -2 and Survivin in Children with Acute Leukemia and Its Significance

Objective To study the expression of cyclooxygenase-2(COX-2) and survivin in children with acute leukemia(AL) and its significance.Method The expression of COX-2 and survivin were determined by immunohistochemical SABC assay.Results The expression rate of COX-2 and survivin were 52.4%(22/42 cases)and 45.2%(19/42 cases)in AL,and the expression rate of COX-2 and survivin were 46.9%(15/32 cases)and 40.6%(13/32 cases)and in acute lymphonate leukemia(ALL),both of them were higher than those in control group(Pa<0.05).COX-2 expression rate in high risk ALL and middle risk-low risk ALL were 54.5% and 42.8%,respectively,and the difference had no stastical significance(Pa>0.05).The positive rate of COX-2 was 84%(16/19 cases)in 19 cases with survivin positive expression,and the negative rate of COX-2 was 85%(17/20 cases)in 20 cases with survivin negative expression,and there was positive correlation between COX-2 expression and survivin expression(r=0.579 P<0.001).The complete remission(CR) rate was higher in COX-2 protein negative patients than that in positive patients(93.3% vs 66.7%),and the difference was statistically significant(P<0.05).Conclusions 1.Expression of COX-2 and survivin increase in children with AL.2.COX-2 and survivin may involve in the development of AL.3.The overexpression of COX-2 may have relationship to the prognosis of AL.