性连锁凋亡抑制蛋白及其拮抗蛋白在急性白血病中表达及意义.doc

性连锁凋亡抑制蛋白及其拮抗蛋白在急性白血病中表达及意义 　 作者：陈广华，林凤茹，任金海，陈静，张静楠，王艳，王静 【摘要】 　　为了研究急性白血病(AL)性连锁凋亡抑制蛋白(X-linked inhibitor of apoptosis proteins，XIAP)和XIAP相关因子1(XIAP-associated factor 1，XAF1)的表达及其临床意义，应用逆转录聚合酶链反应(RT-PCR)法检测116例AL患者和17名正常人骨髓单个核细胞中XIAP、XAF1、Smac和HtrA2 mRNA的表达，并分析其与临床治疗效果的关系。结果表明： 初治AL患者XIAP mRNA表达水平(0.990±0.337)明显高于正常对照(0.395±0.148) (Plt;001)； 初治AL患者XAF1 mRNA阳性率及表达水平(56.3%，0.246±0.267)明显低于正常对照(100%，0.964±0.387) (Plt;0.01)； 69例初治AL患者中高表达XIAP患者完全缓解率明显低于低表达患者(Plt;0.01)； XAF1阳性表达患者完全缓解率明显高于阴性表达患者(Plt;0.01)。结论： XIAP在AL中异常高表达，XAF1在AL中异常低表达，XIAP高表达及XAF1低表达或阴性可能是AL患者不良预后的指标。 【关键词】 XIAP; XIAP相关因子1; Smac; HtrA2; 急性白血病 　　Expression and Significance of X-linked Inhibitor of Apoptosis Protein and Its Antagonized Proteins in Acute Leukemia 　　Abstract To investigate the expression and significance of X-linked inhibitor of apoptosis protein (XIAP) and XIAP-associated factor 1 (XAF1) in acute leukemia，the expression of XIAP，XAF1，Smac，and HtrA2 mRNA in the bone marrow aspirates from 87 newly diagnosed AL patients，23 patients in remission，6 patients in relapse，and 17 normal controls were detected by means of reverse transcriptase polymerase chain reaction (RT-PCR)，and their relationship with clinical therapeutic efficiency was analyzed. The results showed that the expression level of XIAP mRNA in newly diagnosed AL patients (0.990±0.337) was significantly higher than that in normal controls (0.395±0.148) (Plt;001); the positive rate and expression level of XAF1 mRNA in newly diagnosed AL patients (56.32%，0.246±0.267) were significantly lower than that in normal controls (100%，0.964±0.387) (Plt;0.01). In 69 out of 87 newly diagnosed AL patients，efficacy remained evaluable. AL patients with high level of XIAP achieved a lower complete remission (CR) rate than patients with low level of XIAP (54.55% and 86.11%，respectively) (Plt;0.01). XAF1 positive patients achieved a higher CR rate than XAF1 negative patients (86.84% and 51.61%，respectively) (Plt;0.01). It is concluded that the overe