The Study Of Expression Level Of XIAP、MDM2and P53Protein And Clinical Review Of Childhoodacute Lymphoblastic Leukemia

ObjectiveTo study the expression and clinical significance of XIAP、MDM2and P53proteins inchildren with acute lymphoblastic leukemia.Methods⑴SABC immunohistochemistry was used to detect the expression of XIAP、MDM2andP53proteins in49cases of children with acute lymphoblastic leukemia, and20children withnon-maligant blood diseases as the control group.⑵RT-PCR was used to detect the expression of XIAP mRNA in11cases of childrenwith acute lymphoblastic leukemia.Results⑴As the Immunohistochemistry results showed that：the positive expressions of XIAP、MDM2and P53proteins were mostly located in the cytoplasm，only less located in thenucleus. The positive expression rates of XIAP、MDM2and P53proteins in children withacute lymphoblastic leukemia were respectively38.8%(19/49)、40.8%(20/49)、32.7%(16/49)and those expression rates were significantly higher than the control group (p<0.05).⑵There were17cases of children in HR group,7cases expressed XIAP (41%,7/17),6cases had the co-expression of three proteins (35.3%,6/17). There were18cases in MRgroup,7cases expressed XIAP (39%,7/18),2cases had the co-expression of three proteins(11.1%,2/18). There were14cases of children in LR group,4cases expressed XIAP (36%, 5/14),4cases had the co-expression of three proteins (28.6%，4/14). The expression rates ofXIAP in the HR group were higher than the MR group and LR group, but no statisticallysignificant differences within the groups（①X~2=0.019,②X~2=0.022,③X~2=0.088, P>0.05）.The three co-expression group, the three co-expression rates in HR group were slightlyhigher than the MR group and LR group, but no significant differences within the groups（①X~2=2.86,②X~2=1.16,③X~2=0.149, P>0.05）。⑶There were40cases in this experiment accepted prednisone induced treatment,XIAP(+)15cases, the prednisone induced test sensitiveity in12cases (80%，12/15),3caseswere not sensitive. The three co-expression group of12cases,8cases were acceptedprednisone induced treatment, prednisone induced test sensitivity in5cases (62.5%,5/8),3cases were not sensitive. The negative group of25cases, prednisone induced test sensitivityin20cases (80%，20/25)，5cases were not sensitive. They had the same expression ratesbetween the XIAP(+) group and the three negative group induced by prednisone sensitivetest.The rates of the XIAP(+) group and the three negative group were sligthly higher thanthe three co-expression group, but there were no significant difference between each other（X~2=1.011, X~2=0.829, P>0.05）.⑷There were38cases of children with acute lymphoblastic leukemia.There were8cases with continuous complete remission in15cases expressed XIAP in(53%，8/15), the restwere not continuous complete remission. In three co-expression of8cases, there were5caseswith continuous complete remission in(62.5%，5/8), the rest were not continuous completeremission. There negative group of23cases, there were20cases with continuous completeremission in (87%，20/23), the rest were not continuous complete remission. The threenegative group of continuous complete remission by the analysis of XIAP (+) group and threenegative group difference was statistically significan（tX~2=5.293，P<0.05）and higher than thatof XIAP (+) group and three co-expression of the group.The three co-expression group andthe three negative group differences ware not statistically significant （X~2=2.274,P>0.05）.Continuous complete remission rate of XIAP(+) group was slightly less than thethree co-expression group, and no significant difference between the groups（X~2=0.178，P>0.05）. ⑸The XIAP mRNAlevels were detected in11cases by RT-PCR，and overexpressions ofXIAP were found in5cases. They also had high expression of XIAP protein detected byimmunohistochemistry.Conclusion⑴The high expression of XIAP protein may be related to the development of childrenwith acute lymphoblastic leukemia⑵The expression of XIAP was no significant correlation ofALL clinical classification、prednisone induced by test sensitivity and of the bone marrow remisson rate at the day33ofinduction therapy.⑶The positive expression rate of XIAP in continuous complete remission group is low，post less effective, suggesting that XIAP may be a new indicator of poor prognosis forchildhood ALL.