29例慢性淋巴细胞白血病Ki-67及Bcl-2表达及临床意义.doc

29例慢性淋巴细胞白血病Ki-67及Bcl-2表达及临床意义 　 作者：徐卫，李建勇，吴雨洁，盛瑞兰，陆风翔 【摘要】 为了观察Ki-67抗原和抗凋亡蛋白Bcl-2在慢性淋巴细胞白血病（CLL）中的表达，探讨其与CLL疾病分期和预后的关系，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29例CLL患者的骨髓或外周血的增殖相关抗原Ki-67和抗凋亡蛋白Bcl-2进行检测。结果显示： Ki-67抗原在晚期CLL中的表达较早期CLL中的表达高，且差异有显著性；Bcl-2蛋白在晚期CLL中的表达也高于早期CLL中的表达，但差异无显著性；高Ki-67表达组的活存期比低表达组的活存期短，且有显著性差异，而Bcl-2的表达在两组之间无差异。结论：对CLL患者进行增殖相关抗原Ki-67和抗凋亡蛋白Bcl-2的检测，其结果能反映患者肿瘤细胞的增殖活性和凋亡受抑的情况；Ki-67与CLL疾病分期和预后密切相关。 【关键词】 慢性淋巴细胞白血病 　　Expressions of Ki-67 and Bcl-2 in 29 Cases of Chronic Lymphocytic Leukemia and Their Clinical Significance 　　Abstract To investigate the expressions of proliferative antigen Ki-67 and apoptosis-antagonizing protein Bcl-2 in patients with chronic lymphocytic leukemia (CLL) and their clinical significance，immunohistochemistry method was used for detection of Ki-67 and Bcl-2 in bone marrow or peripheral blood of 29 patients with CLL . The results showed that the level of Ki-67 expression in advanced stage of CLL was higher than that in early stage of CLL and there was significant difference between these stages of CLL，but there was no significant difference between expression levels of Bcl-2 in two stages. The survival time in the group with Ki-67 expression ≤8% was longer than that in the group of Ki-67gt;8%，and there was no significant difference of survival time between high and low groups in terms of Bcl-2 expression. It is concluded that detection of Ki-67 antigen and Bcl-2 protein for CLL patients can reflect the status of proliferation activity and apoptosis suppression of leukemia cells in patients; the level of Ki-67 expression closely correlate with the Binet stage and prognosis of CLL. 　　Key words Chronic lymphoblastic leukemia; Ki-67 antigen; Bcl-2 protein; Immunohistochemistry 肿瘤的发生，一方面与调控细胞增殖基因的过度表达及分化调控紊乱有关，另一方面也与细胞凋亡基因的调控异常有关。慢性淋巴细胞白血病（CLL）是一种恶性淋巴增殖性疾病，其预后主要与疾病的分期、骨髓浸润的组织特点、外周血淋巴细胞绝对计数、淋巴细胞倍增时间和分子遗传学改变等有关。CLL细胞的过度增殖和凋亡受抑与CLL的治疗和预后也密切相关。Ki-67抗原为一种细胞核抗原，仅在增殖细胞核中表达［1］，其单克隆抗体被认为是较理想的检测细胞增殖活性的抗体。Bcl-2作为一种重要的凋亡拮抗基因［2］，其蛋白产物与淋巴造血系统肿瘤的