c-IAP2及Smac基因在白血病中表达及其临床意义.docVIP

c-IAP2及Smac基因在白血病中表达及其临床意义 　【摘要】 为了研究c-IAP2及其拮抗素Smac基因在白血病中的表达及对成人急性白血病（AL）患者的预后意义，采用半定量逆转录-聚合酶链反应（RT-PCR）检测103例白血病患者c-IAP2、Smac的mRNA表达水平，20名健康人为正常对照，K562、Kg-1a细胞株为阳性对照。结果表明： c-IAP2、Smac在初治AL中的表达较正常对照组明显升高，两者的表达为高度正相关，治疗缓解后c-IAP2、Smac的表达明显下降，与初治AL组有明显差异（Plt;0.05），复发后c-IAP2、Smac基因的表达又复升高。c-IAP2 mRNA和Smac mRNA在慢性粒细胞性白血病慢性期（CML-CP）组的表达率和表达水平均高于正常对照组，但无统计学意义（Pgt;0.05）。在初治AL患者中，c-IAP2、Smac表达阳性的患者缓解率均低于表达阴性的患者。 结论： c-IAP2 mRNA、Smac mRNA过度表达和急性白血病的发病呈正相关；c-IAP2 、Smac高表达的患者完全缓解率低，预后不良；c-IAP2、Smac可作为急性白血病的发病、复发及预后判断的指标之一。 【关键词】 白血病 　　Expressions of c-IAP2 and Smac Gene in Leukemia and Their Clinical Significance 　　Abstract To investigate the expressions of c-IAP2 and Smac in leukemia and their prognostic significance in adult patients with acute leukemia (AL)，the mRNA expressions of c-IAP2 and Smac in 103 AL adult patients were measured by semi-quantity reverse transcription polymers chain reaction (RT-PCR).Other 20 adults were selected as normal controls (NC)，K562 and Kg-1α cell lines were employed as positive control.The results showed that the expressions of c-IAP2 and Smac in de novo AL patients were higher than those in NC，while they decreased in patients at complete remission (CR). In relapsed patients，the expressions of c-IAP2 and Smac increased again.The mRNA expression of c-IAP2 and Smac in CML-CP were higher than that of NC，but no statistical significance was found (Pgt;0.05).In AL patients，the CR rate of c-IAP2+ and Smac+ cases were lower than those of c-IAP2-and Smac-cases. It is concluded that overexpression of c-IAP1 and Smac may play a synergic role in the pathogenesis of AL，and there is a positive correlation beween them. The c-IAP2 and Smac expressions are associated with remission rate in AL，while the patients with high level of c-IAP2 or Smac have low remission rates. It seems that c-IAP2 and Smac serve as markers of poor prognosis in AL. 　　Key words leukemia; c-IAP2 gene; Smac gene; apoptosis 　　白血病为最常见的肿瘤之一，虽然骨髓移植和联合化疗改善了其预后，但一部分患者仍很难达到完全缓解或缓解后复发。目前的研究显示