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目的 检测急性淋巴细胞白血病 (ALL)患儿体内肿瘤细胞的凋亡情况 ,并初步探讨其临床意义。方法 用Annexin V FITC/PI双标记法检测 2 2例初治ALL患儿化疗前后骨髓白血病细胞的凋亡情况并与患儿的近期化疗疗效及DNA倍性、免疫表型等临床特征进行相关分析。结果 化疗前无一例检出凋亡细胞 ,化疗后 13/2 2例凋亡检测阳性。化疗后患儿白血病细胞的凋亡情况与其早期缓解、DNA倍性、免疫表型有关 (P均 <0 0 5 ) ,与WBC数、年龄、性别、髓外浸润情况无关 (P均 >0 0 5 )。结论 Annexin V FITC/PI双标记法是一种简单、敏感的检测体内凋亡细胞的方法 ;化疗后体内白血病细胞的凋亡情况与近期化疗疗效一致 ;DNA指数 1 16～ 1 6的ALL患儿预后好 ,与其白血病细胞易于凋亡有关 ;成熟B ALL、T ALL患儿预后差 ,与其白血病细胞不易凋亡有关。
Objective To detect the apoptosis of tumor cells in children with acute lymphoblastic leukemia (ALL) and to investigate its clinical significance. Methods The apoptosis of myeloid leukemia cells before and after chemotherapy in 22 children with newly diagnosed ALL was detected by Annexin V FITC / PI double labeling method. The correlations were analyzed with the clinical efficacy, DNA ploidy, immunophenotype and other clinical features . Results No apoptotic cells were detected in all cases before chemotherapy. Apoptosis was detected in 13 of 22 cases after chemotherapy. The apoptosis of leukemia cells in patients with chemotherapy was related to early remission, DNA ploidy and immunophenotype (P <0.05), but not to WBC count, age, sex and extramedullary infiltration (P> 0 0) 5). Conclusion Annexin V FITC / PI double labeling method is a simple and sensitive method for the detection of apoptotic cells in vivo. The apoptosis of leukemic cells in vivo after chemotherapy is consistent with the results of recent chemotherapy. The children with ALL with DNA index of 16 to 16 The prognosis is good, and its leukemia cells are prone to apoptosis; mature B ALL, T ALL children with poor prognosis, and its leukemia cells is not easy to apoptosis.