本文選題：ALL + XIAP��； 參考：《華中科技大學(xué)》2012年碩士論文

【摘要】：目的 研究XIAP、MDM2和P53在兒童ALL中的表達(dá)及意義。 方法 ⑴應(yīng)用免疫組織化學(xué)方法(SABC)檢測49例兒童ALL中XIAP、MDM2和P53蛋白水平的表達(dá)及臨床意義，對照組為20例非惡性血液病患兒。 ⑵應(yīng)用半定量逆轉(zhuǎn)錄聚合酶鏈反應(yīng)（RT-PCR）檢測11例ALL中XIAP mRNA的表達(dá)情況。 結(jié)果 ⑴免疫組化結(jié)果顯示：本實驗對象為49例，自2009年1月～2012年3月收治的兒童ALL患兒。XIAP、MDM2和P53蛋白的表達(dá)多位于胞漿，僅少數(shù)表達(dá)于胞核。XIAP、MDM2和P53在本組49例兒童ALL的陽性表達(dá)率分別為38.8％(19／49)、40.8％(20/49)、32.7%(16/49)，均明顯高于對照組(P0.05)。 ⑵17例高危組（HR）患兒中，XIAP（+）7例（41%，7/17），XIAP/MDM2/P53三者共表達(dá)者6例（35.3%，6/17）。18例中危組（MR）患兒中，XIAP（+）7例（39%，7/18），XIAP/MDM2/P53三者共表達(dá)者2例(11.1%，2/18)。14例低危組（LR）患兒中，XIAP（+）5例（36%，5/14），XIAP/MDM2/P53三者共表達(dá)者4例(28.6%，4/14)。HR組XIAP表達(dá)率高于MR組和LR組，但組間差異均無統(tǒng)計學(xué)意義（①X~2=0.019，②X~2=0.022，③X~2=0.088，P0.05）。HR組XIAP/MDM2/P53三者共表達(dá)率高于MR組和LR組，但組間差異均無統(tǒng)計學(xué)意義（①X~2=2.86，②X~2=1.163，③X~2=0.149，P0.05）。 ⑶本組實驗中接受強(qiáng)的松誘導(dǎo)試驗的病例40例，XIAP（+）表達(dá)者15例，強(qiáng)的松誘導(dǎo)試驗敏感者12例（80%，12/15)，不敏感者3例。XIAP/MDM2/P53共表達(dá)者12例，接受治療8例，強(qiáng)的松誘導(dǎo)試驗敏感者5例（62.5%，5/8），不敏感者3例。三者陰性者25例，對強(qiáng)的松誘導(dǎo)試驗敏感者20例（80%，20/25），5例不敏感。XIAP（+）組與三者陰性組對強(qiáng)的松誘導(dǎo)試驗敏感率一致，略高于XIAP/MDM2/P53三者共表達(dá)組，但組間差異無統(tǒng)計學(xué)意義（X~2=1.011，X~2=0.829，P0.05）。 ⑷在隨訪時間1年的38例ALL患兒中，XIAP（+）組15例，持續(xù)完全緩解者8例(53%，8/15)，未持續(xù)完全緩解者7例。XIAP/MDM2/P53三者共表達(dá)者8例，持續(xù)完全緩解者5例（62.5%，，5/8），未持續(xù)完全緩解者3例。三者陰性者23例，持續(xù)完全緩解者20例（87%，20/23），未持續(xù)完全緩解者3例。三者陰性組持續(xù)完全緩解率高于XIAP（+）組與XIAP/MDM2/P53三者共表達(dá)組，經(jīng)分析后XIAP(+)組與三者表達(dá)均陰性組間差異有統(tǒng)計學(xué)意義(X~2=5.293，P0.05)。XIAP/MDM2/P53三者共表達(dá)組與三者陰性組差異無統(tǒng)計學(xué)意義（X~2=2.274，P0.05）。XIAP（+）組持續(xù)完全緩解率略低于XIAP/MDM2/P53三者共表達(dá)組，組間差異無統(tǒng)計學(xué)意義（X~2=0.178，P0.05）。 ⑸RT-PCR檢測ALL患兒11例，5例表達(dá)XIAP mRNA，該5例患兒均為免疫組化XIAP蛋白表達(dá)陽性者。 結(jié)論 ⑴XIAP的表達(dá)提示可能與兒童ALL的發(fā)生發(fā)展有關(guān)。 ⑵XIAP的表達(dá)與ALL的臨床分型、強(qiáng)的松誘導(dǎo)試驗敏感性及誘導(dǎo)緩解治療第33天骨髓緩解情況無明顯相關(guān)。 ⑶XIAP表達(dá)陽性的ALL患兒持續(xù)完全緩解率低，后期療效較差，提示XIAP可能是兒童ALL后期預(yù)后不良的新指標(biāo)。
[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.
【學(xué)位授予單位】：華中科技大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R733.71

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