CAJ | 학술논문

目的：探讨c-FLIP基因在血液肿瘤中的表达以及临床意义。方法以半定量逆转录聚合酶链反应(RT-PCR)检测22例血液肿瘤骨髓中的c-FLIP mRNA表达，Western-Blot蛋白质印迹(WB)方法检测其c-FLIP蛋白的表达。病例包括急性白血病(AL)12例(其中初治11例及反复复发1例)、完全缓解(CR)后AL 2例、慢性粒细胞性白血病(CML)2例、慢性淋巴细胞性白血病(CLL)2例、多发性骨髓瘤(MM)2例和骨髓增生异常综合征-难治性贫血伴原始细胞增多2型(MDS-RAEB-2)2例。结果初治和复发AL，初治CML、CLL、MDS-RAEB-2、MM患者c-FLIP mRNA和蛋白均表达异常增高。初治AL c-FLIP mRNA及43 kD蛋白的表达显著高于慢性白血病(CL)(P<0.05)。MDS-RAEB-2、MM与ALc-FLIP mRNA的表达差异均无统计学差异(P>0.05)，但MDS 55 KD、43 KD蛋白表达明显低于AL(P<0.05)，而MM无明显差异。对照组mRNA及其蛋白均阴性表达，CR后AL mRNA阴性表达，但其蛋白均有表达，低表达于AL，尤其43 kD明显低于AL(P<0.05)。c-FLIP表达在初治AL患者与其年龄、性别、初诊白细胞数、LDH以及核型、免疫表型无关。AL患者c-FLIP mRNA及其蛋白表达与初治疗效无明显相关性(P>0.05)。结论血液肿瘤患者c-FLIP mRNA及其蛋白表达异常增高，能够反映出恶性血液病患者骨髓造血细胞的凋亡抑制情况，与恶性血液病的类型、疾病的状态以及病程中的临床疗效、预后等都密切相关。
목적：탐토c-FLIP기인재혈액종류중적표체이급림상의의。방법이반정량역전록취합매련반응(RT-PCR)검측22례혈액종류골수중적c-FLIP mRNA표체，Western-Blot단백질인적(WB)방법검측기c-FLIP단백적표체。병례포괄급성백혈병(AL)12례(기중초치11례급반복복발1례)、완전완해(CR)후AL 2례、만성립세포성백혈병(CML)2례、만성림파세포성백혈병(CLL)2례、다발성골수류(MM)2례화골수증생이상종합정-난치성빈혈반원시세포증다2형(MDS-RAEB-2)2례。결과초치화복발AL，초치CML、CLL、MDS-RAEB-2、MM환자c-FLIP mRNA화단백균표체이상증고。초치AL c-FLIP mRNA급43 kD단백적표체현저고우만성백혈병(CL)(P<0.05)。MDS-RAEB-2、MM여ALc-FLIP mRNA적표체차이균무통계학차이(P>0.05)，단MDS 55 KD、43 KD단백표체명현저우AL(P<0.05)，이MM무명현차이。대조조mRNA급기단백균음성표체，CR후AL mRNA음성표체，단기단백균유표체，저표체우AL，우기43 kD명현저우AL(P<0.05)。c-FLIP표체재초치AL환자여기년령、성별、초진백세포수、LDH이급핵형、면역표형무관。AL환자c-FLIP mRNA급기단백표체여초치료효무명현상관성(P>0.05)。결론혈액종류환자c-FLIP mRNA급기단백표체이상증고，능구반영출악성혈액병환자골수조혈세포적조망억제정황，여악성혈액병적류형、질병적상태이급병정중적림상료효、예후등도밀절상관。
Objective To explore c-FLIP (cellular FLICE inhibitory protein) expression and its clinical sig-nificance in hematologic malignancies. Methods Expression level of c-FLIP mRNA and protein in bone marrow mononuclear cells was determined by Semi-Reverse Transcription-Polymerase Chain Reaction (Semi-RT-PCR) and Western blot in 22 patients of hematologic malignancies, which included 11 cases with newly diagnosed acute leuke-mia (AL), 1 case of relapsed AL, 2 cases of AL after complete remission (CR), 2 cases of chronic myelocytic leukemia (CML), 2 cases of chronic lymphocytic leukemia (CLL), 2 cases of multiple myeloma (MM) and 2 cases of mycelo-dysplastic syndrome-refractory anemia with excess blasts-2 (MDS-RAEB-2). Results Expression level of c-FLIP mRNA and protein were higher in patients with newly diagnosed or relapsed AL and newly diagnosed CML, CLL, MDS-RAEB-2, MM. Levels of c-FLIP mRNA and protein of 43 kD were higher in AL than in newly diagnosed chron-ic leukemia (CL), P<0.05. There were no significant differences in mRNA between MDS-RAEB-2, MM and AL (P>0.05). The levels of c-FLIP protein of 55 kD and 43 kD were lower in MDS than those in newly diagnosed AL (P<0.05). The expression of normal subjects in mRNA and protein were negative. The expression of AL after CR was neg-ative in mRNA, but positive in protein, and lower than AL, especially in protein of 43 kD (P<0.05). The expression level of c-FLIP was not associated with age, sex, WBC, LDH, cytogenetic characteristics, immunophenotype (P>0.05). There were no significant differences in that of curative effect (P>0.05). Conclusion c-FLIP was highly ex-pressed in hematologic malignancies. The level of expression reflected apoptosis of hematologic malignancies, and was closely related with the type and situation of hematologic malig-nancies, chemotherapeutic effects and prognosis.