Studies On The Expression Of Substance P And Its Clinical Appcations In Human Blast Cells In Lymphoblastic Leukaemia

Objective: The study focused on determing the expression of substance P (SP) in neoplastic cells of acute lymphoblastic leukaemia (ALL) at the levels of its protein production, to explore the correlation between the levels of substance P and acute lymphoblastic leukaemia. This may help to know the role of substance P in the ALL;the change of the substance P may contribute to prevetion, diagnosis, therapy and prognosis in clinic.Methods: Select 44 cases of ALL verdure bone marrow smears. First using an immunocytochemical stain technique APAAP with McAb for CD₅, CD₇, CD₁₀,CD₁₉, CD₃₃, HLA-DR antigens in blast immunophenotyping. Then SP detection involved the use of an immunocytochemical procedure with rabbit polyclonal antibodies against human substance P and the streptABC/HRP method. The reaction position produce palm sediment reveals positive result, count the percent of positive cells, and measure the developments of part cases, collect 16 cases bone marrow smear of ALL completed remission as a case control group aside, select another 20 normal bone marrow cases as control group, use the same method detect the level of substance P.Results: By immunocytochemical stain, there are 33 cases of B-ALL and 11 cases of T-ALL in 44 ALL patients. In 44 ALL patients, the total SP- positive cases is 23 , the percentage is 52.27% (23/44), and the mean positive percent is 83.7%, while In none of the analyzed bone marrow biopsies obtained from control group could detect the expression of SP be confirmed by this method. In patients of B-cell leukaemia the SP-positive cases is 14 , the percentage is 42.42%( 14/33), and the mean positive percent is 78.8%;while in patients of T-cell leukaemia, the SP- positive cases is 9 , the percentage is 81.81%(9/11), and the mean positive percent of SP- positive cases is 91.3 %. The SP-positive percentage of T-ALL is much higher than B-ALL(P=0.0365),and the mean positive percent of T-ALL is higher than B-ALL(t=6.22, P < 0.01).Select 33 cases from 44 for development measure, including 18 SP- positive cases and 15 SP- negative cases. 28 patients of the 33 were remission after one to three therapyof VP, VBC1P methods (20 cases CR, 8 cases PR), in which 13 cases SP- positive cases gain remission, the percentage of remission is 72.22%(13/18), while all of the 15 SP-negative cases gain remission in the same time, the percentage of remission is 100%. The remission percentage of SP- positive cases is much lower than SP- negative cases(P= 0.0488).Only 2 cases of SP- positive group can be detected the expression of SP in remission period, the percentage of SP- positive cases is 15.39%(2/13), the percentage of remission group became decreased , the difference has a significant compared with ALL group(P=0.0259), and the mean positive percent is also decreased(t=l 2.5133, P < 0.05).The 16 complete remission group, including 1 leases of B-ALL and 5 cases of T-ALL. Only one case detect the expression of SP, the percentage of SP- positive cases is 6.25%, and the mean positive percent of SP- positive cases is 34%;the expression of SP decreased compared with ALL group(P=0.0020).Conclusion: (J)The percentage of SP- positive cases and the mean positive percent of SP- positive cases were increased significantly compared with remission group, means SP may play a role in the acute lymphoblastic leukemia, this may help us explore the mechanism of ALL. (2)The percentage of SP- positive and the mean positive percent of SP in T-ALL increased significantly compared with B-ALL, expression of SP maybe related with immunophenotyping, and help prognosis of ALL in clinic. d)The remission of SP- positive patients were lower than SP- negative patients, this means the expression of SP has a correlation with therapy and prognosis of ALL, SP- positive patients has a bad prognosis, while SP- negative patients has a better prognosis.