目的:探讨和分析白血病bcl-2,p170,CD34表达的临床意义及其相关性.方法:用ABC免疫细胞化学法检测77例急性白血病和23例慢性粒细胞白血病bcl-2,p170,CD34的表达.结果:复发、难治急性白血病bcl-2,p170,CD34的表达率明显高于初治急性白血病;bcl-2,p170,CD34高表达的急性白血病完全缓解率显著低于不表达或低表达者;加速/急变期的慢性粒细胞白血病CD34表达高于慢性期;bcl-2高表达的阳性符合率为90.9%,略高于p170或CD34;白血病bcl-2,p170的表达有轻度正相关性(r=0.386,P<0.001).结论:bcl-2为较敏感的临床预测指标,联合检测bcl-2,p170,CD34可能提高单一指标的预测价值.CD34可能是CML病程进展的指标.而不同多药耐药机制可能有一定的联系.%Objective:To study and assess the clinical significance of the expressions of bcl－2,p170,and CD34 in leukemia and their correlations. Methods:ABC immunocytochemistry was used in detection of the expressions of bcl－2,p170,and CD34 in leukemic cells from 77 cases of acute leukemia(AL)and 23 cases of chronic myeloid leukemia (CML) patients. Results:The expression rates of bcl－2,p170,and CD34 in relapsed or refractory acute leukemia were significantly higher than those in the untreated acute leukemia. The complete remission rates were significantly lower in the patients with overexpression than in those with low－/non－expression of one of the detected markers,bcl－2,p170 and CD34. The expression of CD34 in CML accelerative or excess blast phase was higher than that in chronic phase. It was found that the positive coincidence rates were 90.9％ for overexpression of bcl－2,which was a little higher than that of p170 or CD34. It was showed that there was slightly positive correlation between the expression rates of bcl－2 and p170 (r=0.386,P<0.001). Conclusion:There is more sensitive predictive value of bcl－2 among these three markers. The combined detection of bcl－2,p170 and CD34 may improve the predictive value of each. It was also suggested that CD34 could be a poor indicator in the course of CML. There may be some correlation among the different MDR mechanisms.
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