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目的 :观察原位细胞凋亡与急性白血病 (AL )发生与转归的关系。方法 :用碱性磷酸酶抗碱性磷酸酶(APAAP)免疫酶标和 DNA末端原位标记 (ISEL )双重染色方法检测 49例急性白血病骨髓涂片中细胞凋亡状况 ,初治组 2 3例与 15例缺铁性贫血病例对照并与 2 6例经治病例对照。结果 :未经治疗的 AL 平均凋亡指数 (AI)明显低于对照组 (P <0 .0 1)。化疗后凋亡明显增加 ,与化疗前比较差异有极显著性意义 (P <0 .0 1)。AI>5 %者平均原始细胞下降指数 (MBDI)为 2 8.6 8% ,AI<5 %者平均 MBDI仅为 4.9%。凋亡细胞大多数为白血病细胞。非白血病细胞凋亡亦有增加。结论 :AL 发生与凋亡逃逸有关 ,细胞毒化疗的主要机理之一为促进细胞凋亡。化疗后全血细胞下降与正常造血细胞凋亡增加有关。
Objective: To observe the relationship between apoptosis in situ and the occurrence and prognosis of acute leukemia (AL). METHODS: Apoptosis was detected in 49 bone marrow smears of acute leukemia by alkaline phosphatase anti-alkaline phosphatase (APAAP) immuno-enzyme labeling and DNA-end in situ labeling (ISEL) dual staining methods. The initial treatment group was 23 cases. It was compared with 15 cases of iron deficiency anemia and compared with 26 cases of treated cases. Results: The average apoptotic index (AI) of untreated AL was significantly lower than that of the control group (P < 0.01). Apoptosis was significantly increased after chemotherapy, which was significantly different from that before chemotherapy (P < 0.01). The mean original cell decline index (MBDI) of AI>5 % was 28.68%, and the mean MBDI was only 4.9% for AI<5%. Most of the apoptotic cells are leukemia cells. Non-leukemia cell apoptosis also increased. Conclusion: The occurrence of AL is related to apoptosis and escape. One of the main mechanisms of cytotoxic chemotherapy is to promote apoptosis. The decline of whole blood cells after chemotherapy is associated with increased apoptosis of normal hematopoietic cells.