摘要
目的探讨促凋亡蛋白Smac、HtrA2在儿童急性白血病（AL）中的表达，分析二者的关系及临床意义。方法77例AL患儿，其中初诊组32例，缓解组33例，复发组12例；15例非恶性血液病患儿作为对照组。采用免疫组织化学过氧化物酶标记链霉卵白素染色（SP）法检测患儿骨髓中Smac、HtrA2蛋白表达情况。应用SPSS13．0软件对结果进行分析。结果所有检测标本仅部分表达Smac，而HtrA2则在所有检测标本中均表达；初诊组患儿骨髓中Smac、HtrA2表达水平均高于缓解组（χ^2=17．38、F=2．36，P均〈0．05）和对照组（χ^2=12．89、F=5．26，P均〈0．05），差异均有统计学意义，但与复发组比较差异均无统计学意义（χ^2=1．18、F=1．57，P均〉0．05）；缓解组二者表达水平均高于对照组，但差异均无统计学意义（χ^2=1．20、F=2．23，P均〉0．05）。初治AL患儿骨髓中Smac、HtrA2蛋白表达水平在急性淋巴细胞白血病（ALL）组和急性髓系自血病（AML）组比较差异均无统计学意义（χ^2=0．113、t=1．024，P均〉0．05）。初诊组AL完全缓解率在Smac蛋白表达阴性（Smac^-）患者组（90．9％）、HtrA2蛋白低表达（HtrA2^low）患者组（84．6％）分别明显高于Smac蛋白表达阳性（Smac^＋）组（47．6％）、HtrA2蛋白高表达（HtrA2^high）组（47．4％），差异均有统计学意义（χ^2=5．772、4．596，P均〈0．05）；Smac^-HtrA2^low表达组完全缓解率（100％）明显高于Smac^＋HtrA2^high表达组（30．8％），差异有统计学意义（χ^2=9．692，P〈0．01）。初治AL患儿骨髓中Smae、HtrA2蛋白表达水平呈正相关（r=0．979，P〈0．001）。结论促凋亡蛋白Smae、HtrA2可能参与了儿童AL的发生与病情变化过程，且二存在此过程中相互影响。在初诊患儿中二者表达水平与白血病临床类型可能无关，但Smae、HtrA2蛋白高表达提示预后不良。
Objective To investigate the expression and clinical significance of Smac and HtrA2 in children with acute leukemia（AL）. Methods Bone marrow samples were obtained from 77 children with AL （including 32 newly diagnosed children,33 complete remission children and 12 relapsed children）and the control group of 15 children without malignant blood disease. The expressions of Smac and HtrA2 protein were measured by streptavidin/peroxidase immunoperoxidase technique（SP） in all children. SPSS 13.0 software was applied to analyze the statistical data. Results Protein Smac was detected only in some samples, but HtrA2 was detected in all samples. The levels of Smac and HtrA2 protein in newly diagnosed AL children were both higher than those of the complete remission children （χ^2 = 17.38 ,F =2.36,all P 〈0.05） and normal controls（χ^2 = 12.89,F =5.26,all P 〈0.05） ,there was a statistical significance,but compared with those in the relapsed children, the difference had no statisticalslgmficance（χ^2 = 1. 18, F = 1.57, all P 〉 0.05 ）. The levels of Smac and HtrA2 protein in complete remission children were both higher than those of the normal controls,and the difference had no statisticalsignificance （χ^2 = 1.20, F = 2. 23, all P 〉 0.05 ）. In the newly diagnosed children, the levels of Smac and HtrA2 protein in children with acute lymphocytic leukemia（ALL） were higher than those of the acute myeloid leukemia（AML） , but the differences had no statisticalsignificance （χ^2 = 0. 113, t = 1. 024,all P 〉 0.05 ）. In newly diagnosed AL children,the complete remission（CR） rate of the negative expression of Smac （ Smac - ,90.9% ）and the low expression of HtrA2 （ HtrA2^low, 84.6% ） in the level of protein were higher than those of the positive expression of Smac（ Smac ＋ ,47.6% ） and the high expression of HtrA2 （ HtrA2high ,47.4% ）, and there was statistical significance respeefively（χ^2 = 5. 772,4.596, all P 〈 0.05 ）. The CR rate of Smae - HtrA2^low group
出处
《中华实用儿科临床杂志》
CAS
CSCD
北大核心
2015年第3期207-210,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
河南省医学科技攻关计划项目（200803077）
