XIAP在儿童急性淋巴细胞白血病表达的研究

发布时间：2018-06-28 18:33

本文选题：ALL + XIAP　；参考：《华中科技大学》2012年硕士论文

【摘要】：目的研究XIAP、MDM2和P53在儿童ALL中的表达及意义。方法 ⑴应用免疫组织化学方法(SABC)检测49例儿童ALL中XIAP、MDM2和P53蛋白水平的表达及临床意义，对照组为20例非恶性血液病患儿。 ⑵应用半定量逆转录聚合酶链反应（RT-PCR）检测11例ALL中XIAP mRNA的表达情况。结果 ⑴免疫组化结果显示：本实验对象为49例，自2009年1月～2012年3月收治的儿童ALL患儿。XIAP、MDM2和P53蛋白的表达多位于胞浆，仅少数表达于胞核。XIAP、MDM2和P53在本组49例儿童ALL的阳性表达率分别为38.8％(19／49)、40.8％(20/49)、32.7%(16/49)，均明显高于对照组(P0.05)。 ⑵17例高危组（HR）患儿中，XIAP（+）7例（41%，7/17），XIAP/MDM2/P53三者共表达者6例（35.3%，6/17）。18例中危组（MR）患儿中，XIAP（+）7例（39%，7/18），XIAP/MDM2/P53三者共表达者2例(11.1%，2/18)。14例低危组（LR）患儿中，XIAP（+）5例（36%，5/14），XIAP/MDM2/P53三者共表达者4例(28.6%，4/14)。HR组XIAP表达率高于MR组和LR组，但组间差异均无统计学意义（①X~2=0.019，②X~2=0.022，③X~2=0.088，P0.05）。HR组XIAP/MDM2/P53三者共表达率高于MR组和LR组，但组间差异均无统计学意义（①X~2=2.86，②X~2=1.163，③X~2=0.149，P0.05）。 ⑶本组实验中接受强的松诱导试验的病例40例，XIAP（+）表达者15例，强的松诱导试验敏感者12例（80%，12/15)，不敏感者3例。XIAP/MDM2/P53共表达者12例，接受治疗8例，强的松诱导试验敏感者5例（62.5%，5/8），不敏感者3例。三者阴性者25例，对强的松诱导试验敏感者20例（80%，20/25），5例不敏感。XIAP（+）组与三者阴性组对强的松诱导试验敏感率一致，略高于XIAP/MDM2/P53三者共表达组，但组间差异无统计学意义（X~2=1.011，X~2=0.829，P0.05）。 ⑷在随访时间1年的38例ALL患儿中，XIAP（+）组15例，持续完全缓解者8例(53%，8/15)，未持续完全缓解者7例。XIAP/MDM2/P53三者共表达者8例，持续完全缓解者5例（62.5%，，5/8），未持续完全缓解者3例。三者阴性者23例，持续完全缓解者20例（87%，20/23），未持续完全缓解者3例。三者阴性组持续完全缓解率高于XIAP（+）组与XIAP/MDM2/P53三者共表达组，经分析后XIAP(+)组与三者表达均阴性组间差异有统计学意义(X~2=5.293，P0.05)。XIAP/MDM2/P53三者共表达组与三者阴性组差异无统计学意义（X~2=2.274，P0.05）。XIAP（+）组持续完全缓解率略低于XIAP/MDM2/P53三者共表达组，组间差异无统计学意义（X~2=0.178，P0.05）。 ⑸RT-PCR检测ALL患儿11例，5例表达XIAP mRNA，该5例患儿均为免疫组化XIAP蛋白表达阳性者。结论 ⑴XIAP的表达提示可能与儿童ALL的发生发展有关。 ⑵XIAP的表达与ALL的临床分型、强的松诱导试验敏感性及诱导缓解治疗第33天骨髓缓解情况无明显相关。 ⑶XIAP表达阳性的ALL患儿持续完全缓解率低，后期疗效较差，提示XIAP可能是儿童ALL后期预后不良的新指标。
[Abstract]:Objective to study the expression and significance of MDM2 and p53 in children with all. Methods 1 Immunohistochemical assay (SABC) was used to detect the expression of MDM2 and p53 protein in 49 children with all and their clinical significance. The expression of XIAP mRNA in 11 cases of all was detected by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Results 1 Immunohistochemical results showed that the expression of MDM2 and p53 proteins in all children from January 2009 to March 2012 were mostly located in the cytoplasm. The positive rates of MDM2 and p53 were 38.8% (19 / 49), 40.8% (20 / 49) and 32.7% (16 / 49) in all, respectively, which were significantly higher than those in control group (P0.05). Among 217 children with high risk group (HR), 7 cases (411717) had XIAP (41717) XIAP-MDM2 / p53 co-expression. XIAP (35.3% 17) .18 cases of moderate risk group (Mr), 7 cases (39 / 18) XIAP-MDM2 / p53, 2 cases (11.1%) .14 cases of low risk group (LR), 5 cases (36R / 514) XIAPMDM2P / P53 co-expressed in 4 cases (28.6m / 414) .HR group XIAP expression rate was higher than that in Mr group and LR group, 5 cases (36R / 514) XIAPMDM2P / P53 co-expression rate was higher than that in Mr group and LR group, and the XIAP expression rate in HR group was higher than that in Mr group and LR group, and the expression rate of XIAP in XIAP group was higher than that in R group and LR group, and the XIAP expression rate in HR group was higher than that in R group and LR group. However, there was no significant difference between the two groups (1XT 2 0.019 0. 022 2 X P0. 022 0. 022). The co expression rate of XIAP / MDM 2 / p53 in HR group was higher than that in Mr group and LR group, but the coexpression rate of XIAP / MDM2 / p53 in HR group was higher than that in Mr group and LR group. However, there was no significant difference between the two groups (1XT 2.86U 2XT 1.163X + 0.149p0.05). 3 in this study, 40 cases received prednisone induction test (40 cases) and 15 cases (15 cases) were treated with prednisone induction test (P05), and 15 cases (15 cases) received prednisone induction test, and 15 cases (15 cases) were treated with prednisone induction test. 12 cases were sensitive to prednisone induction test (80 / 15), 3 cases were insensitive. XIAP / MDM2 / p53 was coexpressed in 12 cases, 8 cases were treated, 5 cases (62.5% / 8) were sensitive to prednisone induction test, and 3 cases were insensitive. The sensitivity rate of prednisone induction test to prednisone induction test was higher in the prednisone induction test group (n = 25) than in the XIAP / MDM _ 2 / P _ 53 coexpression group (n = 25), and the sensitivity rate of prednisone induction test in the XIAP (n = 5) group was higher than that in the XIAP / MDM _ 2 / P _ 53 co-expression group. But there was no significant difference between the two groups (P 0.05). 4 among 38 children with all, 15 were in the XIAP () group, 8 were in the complete remission group (53 / 15), and 7 were not sustained complete remission. The expression of XIAP / MDM2 / p53 was found in 8 of the 38 children who were followed up for one year. There were 5 cases of sustained complete remission (62.5% / 8) and 3 cases of unsustained complete remission. 23 cases were negative, 20 cases sustained complete remission (87% 20% 23), and 3 cases had no sustained complete remission. The sustained complete remission rate of the three negative groups was higher than that of the XIAP () group and the XIAPP / MDM2 / p53 co-expression group. There was no significant difference between XIAP (XIAP) group and three negative expression groups (XIAP-MDM2 / p53). There was no significant difference between XIAP-MDM2 / p53 co-expression group and three negative groups (XIAP-MDM2 / p53 co-expression group) (XIAP (XIAP) group) was slightly lower than XIAP-MDM2 / p53 co-expression group (P < 0.05), XIAP (XIAP) group was slightly lower than XIAP-MDM2 / p53 co-expression group. 5 the expression of XIAP mRNAs was detected by RT-PCR in 11 children with all and 5 with XIAP mRNAs, all of them were positive for XIAP protein expression by immunohistochemistry. Conclusion 1the expression of XIAP may be related to the occurrence and development of all in children. 2 the expression of XIAP may be related to the clinical classification of all. There was no significant correlation between the sensitivity of prednisone induction test and bone marrow remission on the 33rd day of induced remission. The results suggest that XIAP may be a new indicator of poor prognosis in children with all.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R733.71

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