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目的探讨儿童急性白血病(AL)骨髓细胞中Notch1蛋白表达及其与免疫分型、治疗效果的关系。方法收集2007年1月至2009年1月华中科技大学同济医学院附属同济医院初诊49例AL患儿和20例非恶性血液病患儿骨髓涂片,采用免疫组织化学链霉素亲和素-生物素-过氧化酶复合物(SABC)方法检测骨髓细胞中Notch1蛋白表达情况;流式细胞仪确定白血病细胞免疫分型;标准化疗方案用于AL患儿的治疗。结果 Notch1在T淋巴细胞性白血病(T-ALL)患儿阳性表达率为77.8%,显著高于B淋巴细胞白血病(B-ALL)患儿(31.0%,P<0.05)及对照组骨髓组织(15.0%,P<0.05)。急性非淋巴细胞白血病(ANLL)Notch1蛋白阳性表达率为63.6%,显著高于对照组(15.0%,P<0.05)。在T-ALL和ANLL中,Notch1与治疗效果无明显相关性;但在随访半年以上的B-ALL中,治疗效果好组(完全缓解无复发)Notch1阳性表达率为21.4%,效果差组(死亡或复发)Notch1阳性表达率为80.0%,两者比较差异有统计学意义(P<0.05)。结论 Notch1在儿童AL中的异常表达与免疫分型关系密切。Notch1蛋白在B-ALL中虽然表达率不高,但可能是预后不良的因素。
Objective To investigate the expression of Notch1 protein in childhood acute leukemia (AL) bone marrow cells and its relationship with immunophenotyping and therapeutic effect. Methods A total of 49 children with AL and 20 children with non-hematologic malignancies were recruited from January 2007 to January 2009 in Tongji Medical College, Huazhong University of Science and Technology. The bone marrow smear was performed by immunohistochemical streptavidin- The biotin-peroxidase complex (SABC) method was used to detect the expression of Notch1 protein in bone marrow cells. The immunocytotyping of leukemia cells was confirmed by flow cytometry. The standard chemotherapy was used in the treatment of AL children. Results The positive expression rate of Notch1 in T-ALL patients was 77.8%, significantly higher than that in B-ALL patients (31.0%, P <0.05) and in control group 15.0%, P <0.05). The positive rate of Notch1 protein in acute non-lymphocytic leukemia (ANLL) was 63.6%, which was significantly higher than that in control group (15.0%, P <0.05). In T-ALL and ANLL, there was no significant correlation between Notch1 and the effect of treatment. However, the positive rate of Notch1 was 21.4% in the well-treated group (complete remission without recurrence) in the B-ALL patients followed up for more than six months. Death or recurrence), the positive rate of Notch1 was 80.0%, the difference was statistically significant (P <0.05). Conclusion The abnormal expression of Notch1 in children with AL is closely related to the immunophenotyping. Notch1 protein in B-ALL although the expression rate is not high, but it may be a poor prognosis factor.