儿童与成人急性淋巴细胞白血病中Ki-67与Bcl-2表达的临床意义.docVIP

儿童和成人急性淋巴细胞白血病中Ki-67和Bcl-2表达的临床意义 （作者:___________单位: ___________邮编: ___________） 作者：徐卫, 李建勇, 吴雨洁, 盛瑞兰, 陆凤翔 【摘要】 为了观察Ki-67和Bcl-2在儿童和成人ALL中的表达，探讨其与ALL免疫学分型和临床疗效的关系，用链霉菌抗生物素蛋白-碱性磷酸酶（SAP）免疫组织化学染色的方法，对18例儿童急性淋巴细胞白血病（ALL）和43例成人ALL患者的骨髓或外周血进行Ki-67抗原和Bcl-2蛋白的检测。结果表明：Ki-67抗原在儿童ALL中的表达略低于成人ALL，但差异无显著性（P0.05）；而Bcl-2蛋白在儿童ALL中的表达显著低于成人ALL（P0.05）；在儿童和成人ALL各免疫表型中，T细胞、伴有髓系抗原标记的急性淋巴细胞白血病（My+ALL）的Ki-67阳性表达率显著高于成人（P0.05）；儿童和成人ALL的完全缓解率（CR）在Ki-67和Bcl-2两项同时低表达组中最高，仅一项低表达组中次之，两项均高表达组中最低。结论：对儿童和成人ALL患者进行增殖相关抗原Ki-67和抗凋亡蛋白Bcl-2的检测，能反映患者肿瘤细胞的增殖活性和凋亡抑制情况，Ki-67和Bcl-2的表达与白血病ALL类型和临床疗效密切相关。 【关键词】 急性淋巴细胞白血病；Ki-67 抗原；Bcl-2蛋白；免疫组织化学 　　Expression of Ki-67 and Bcl-2 in Adults and Children with Acute Lymphoblastic Leukemia and Its Clinical Significance 　　AbstractTo evaluate the expressions of proliferative antigen Ki-67 and apoptosis-antagonizing protein Bcl-2 as well as their clinical significance， immunohistochemistry staining with SAP was used to detect Ki-67 antigen and Bcl-2 protein in 18 cases of children with acute lymphoblastic leukemia (ALL) and 43 cases of adults with ALL. The resalts showed that the levels of Ki-67 and Bcl-2 expression in children with ALL were lower than that in adults, but only Bcl-2 expression had significant difference. Both in children and in adults, the levels of Ki-67 expression in T-ALL and My+ALL were higher than that in B-ALL and null-ALL. The highest complete remission rate (CR) was seen in the group with lower expression of both indexes ( Ki-67 and Bcl-2). The lowest CR rate was seen in the group with higher expression of both indexes. It is concluded that the levels of Ki-67 and Bcl-2 expression in children and adults with ALL were closely related with the subtype of ALL and chemotherapeutic effects. 　　Key wordsacute lymphoblastic leukemia; Ki-67 antigen; Bcl-2 protein; immunohistochemistry 　　急性淋巴细胞白血病（ALL）是一种恶性淋巴增殖性疾病，白血病细胞的过度增殖和凋亡受抑是ALL的发病基础，与ALL的治疗和预后也密切相关。对ALL细胞进行增殖和凋亡的研究，有助于揭示部分ALL的发生、发展的机制，为ALL的诊断、治疗和预后提供有价值的指标。我们采集了18例儿童ALL和43例成人ALL患者的骨髓或外周血，