成人初发急性淋巴细胞白血病中 CD95、活性半胱天冬酶-3 和 Bcl-2 表达的预后价值。

Prognostic Value of CD95, Active Caspase-3, and Bcl-2 Expression in Adult Patients with De Novo Acute Lymphoblastic Leukemia.

机构信息

Departamento de Hematología, Unidad Médica de Alta Especialidad, Hospital de Especialidades, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México; Departamento de Morfología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, México.

Departamento de Morfología, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Ciudad de México, México.

出版信息

Arch Med Res. 2018 Jan;49(1):44-50. doi: 10.1016/j.arcmed.2018.04.006. Epub 2018 Apr 19.

DOI:10.1016/j.arcmed.2018.04.006

PMID:29680307

Abstract

BACKGROUND

Acute lymphoblastic leukemia is an aggressive malignant disease with high mortality rates in adults.

AIM OF THE STUDY

The expression levels of CD95, active caspase-3, and Bcl-2 were determined in 111 patients with de novo acute lymphoblastic leukemia (ALL) and correlated with overall survival (OS) and disease-free survival (DFS).

METHODS

The immunophenotyped ok leukemia and the expression of CD95, active caspase-3, and Bcl-2, were determined by flow cytometry. Apoptotic variables were correlated by Spearman test, and survival by Kaplan-Meier method. Log-rank test was used to compare survival curves.

RESULTS

From a total of 111 patients, 56 cases were B-ALL, 16 T-ALL, 16 B-ALL/CD33, and 23 ambiguous lineage-AL (AmbLin-AL). The median expression of CD95 (61.5%) and active-caspase-3 (19.4%) was higher in T-ALL (p <0.05), whereas Bcl-2 was lower in T-ALL (p <0.038). There was a highly significant correlation in B-ALL, B-ALL/CD33 and AmbLin-AL between CD95 and Bcl-2, CD95-Active caspase-3, and Bcl-2-Active caspase-3; while in T-ALL, there was only a correlation between CD95-Active caspase-3, and Bcl-2-Active caspase-3. OS and DFS were better for T-ALL than the other groups, especially in patients having higher values of CD95 and active caspase 3, and lower values of Bcl-2. The worse survival rates were observed in patients with B-ALL/CD33, and AmbLin-AL.

CONCLUSIONS

The prognosis of ALL in adults is influenced by the expression levels of Bcl-2, active-caspase-3, and CD95.

摘要

背景

急性淋巴细胞白血病是一种侵袭性恶性疾病，成人死亡率较高。

目的

本研究旨在检测 111 例初诊急性淋巴细胞白血病（ALL）患者 CD95、活性半胱天冬酶-3 和 Bcl-2 的表达水平，并与总生存期（OS）和无病生存期（DFS）相关联。

方法

采用流式细胞术检测免疫表型确定急性白血病和 CD95、活性半胱天冬酶-3 和 Bcl-2 的表达。采用 Spearman 检验相关性，Kaplan-Meier 法分析生存情况。Log-rank 检验比较生存曲线。

结果

共纳入 111 例患者，其中 B-ALL 56 例，T-ALL 16 例，B-ALL/CD33 16 例，AmbLin-AL 23 例。T-ALL 中 CD95（61.5%）和活性-caspase-3（19.4%）的中位表达较高（p<0.05），而 T-ALL 中 Bcl-2 较低（p<0.038）。B-ALL、B-ALL/CD33 和 AmbLin-AL 中 CD95 与 Bcl-2、CD95-活性-caspase-3 和 Bcl-2-活性-caspase-3 之间存在高度显著相关性；而在 T-ALL 中，仅 CD95-活性-caspase-3 与 Bcl-2-活性-caspase-3 之间存在相关性。与其他组相比，T-ALL 的 OS 和 DFS 更好，尤其是 CD95 和活性 caspase-3 值较高，Bcl-2 值较低的患者。B-ALL/CD33 和 AmbLin-AL 患者的生存率较差。