Objective: To explore the expression of cellular apoptosis susceptibility protein （CAS） in acute myeloid leukemia （AML） and its correlation with clinical characteristics.
Methods: The expression of CAS in bone marrow tissue of 54 patients with AML and 24 patients with non-hematological malignant diseases was detected by Western blot and immune-histochemical method, and compared between AML group and control group. Also the relationship of CAS expression in AML and sex, age, WBC count, Hb, platelet count, bone marrow blast cell ratio, ki-67 index, cytogenetic and molecular biological prognostic risk stratification, extramedullary infiltration and other clinical characteristics was analyzed.
Results: Western blot showed that the expression of CAS protein in bone marrow biopsies of AML patients was significantly higher than that in control group (P<0.05). Immune-histochemical method revealed that CAS was mainly located in the cytoplasm in both AML group and control group. Among 54 AML patients, 14 patients (25.9%) showed high expression of CAS, while all the 24 patients in the control group showed low expression of CAS. The high expression rate of CAS in AML patients was significantly higher than that in the control group (P<0.05). There were statistically significant differences in prognostic risk stratification and the remission rate of the first chemotherapy between CAS high expression group and CAS low expression group in AML (P<0.05). The proportion of high risk patients and unremission patients after the first chemotherapy in CAS high expression group were significantly higher than those in CAS low expression group (57.1% vs 27.5%, 30.8% vs 7.9%), while the proportion of low risk patients and complete remission patients after the first chemotherapy were significantly lower than those in CAS low expression group (14.3% vs 37.5%, 53.8% vs 84.2%). In AML patients, the ki-67 index of bone marrow tissue in CAS high expression group was higher than that in CAS low expression group (60% vs 50%) (P<0.05).
Conclusion: CAS is localized in cytoplasm in both AML and non-hematological malignant diseases, and its expression increases in AML. CAS is related to the risk stratification of cytogenetics and molecular biology, the remission rate after the first chemotherapy and ki-67 index in AML, which suggests that CAS may be involved in the occurrence and development of AML.
题目: CAS在急性髓系白血病患者中的表达及临床意义.
目的: 探讨急性髓系白血病（AML）中的细胞凋亡易感蛋白（CAS）的表达及其与临床特征的相关性.
方法: 采用蛋白免疫印迹法和免疫组化法检测54例AML患者和24例非血液系统恶性疾病患者骨髓组织中CAS的表达，比较AML组和对照组CAS表达水平，并分析其在AML中的表达与性别、年龄、外周血白细胞数、血红蛋白及血小板计数、骨髓原始细胞比例、ki-67指数、细胞遗传学和分子生物学预后危险度分层、髓外浸润等临床特征的关系.
结果: 蛋白免疫印迹法结果显示，AML患者骨髓活检组织中的CAS蛋白表达显著高于对照组（P<0.05）。免疫组化法检测结果显示，AML组和对照组CAS均主要定位于胞浆。54例AML患者中，CAS高表达者14例（25.9%），对照组24例患者中CAS全部低表达，AML组中CAS高表达率明显高于对照组（P<0.05）。AML患者中CAS高表达组和CAS低表达组之间，预后危险度分层及首次化疗缓解率有差异，且差异有统计学意义（P<0.05）。CAS高表达组的高危患者和首次化疗后未缓解的患者所占比例明显高于CAS低表达组（57.1% vs 27.5% , 30.8% vs 7.9%），低危患者和首次化疗后完全缓解的患者所占比例明显低于CAS低表达组（14.3% vs 37.5% , 53.8% vs 84.2%）。AML患者中，CAS高表达组患者骨髓组织中Ki-67指数高于CAS低表达组（60% vs 50%）（P<0.05）.
结论: CAS在AML和非血液系统恶性疾病中均定位于细胞浆，且在AML中表达量增加，并与患者细胞遗传学和分子生物学预后危险度分层、首次化疗后缓解率及ki-67指数相关，提示CAS可能参与了AML的发生、发展.
Keywords: acute myeloid leukemia; cellular apoptosis susceptibility; prognosis.