为探讨ｂｃｌ－２、ｐ５３基因蛋白在急性白血病（ＡＬ）细胞表达水平、相互关系及对化疗药耐受的影响，采用免疫组化方法检测ｂｃｌ－２及ｐ５３蛋白阳性水平，临床及体外实验以细胞凋亡为指标观察ｂｃｌ－２蛋白与ＡＬ对ＤＮＲ的耐受。结果：ｐ５３和ｂｃｌ－２蛋白在４６例ＡＬ细胞的阳性率分别为２１７％和６３０％（Ｐ＞００５），与细胞类型、病情有关。ｂｃｌ－２阳性在耐药组多于在缓解组（８８５％、３５０％，Ｐ＜００１）。两种蛋白均阳性的８例均不缓解，均阴性者的缓解率为１１／１３。１例ｂｃｌ－２低表达ＡＬ细胞与ＤＮＲ（１０ｍｇ／Ｌ）共育后有明显的细胞凋亡，４例高表达者加大药物剂量才发生。结果提示，成人ＡＬ细胞有ｂｃｌ－２和ｐ５３蛋白异常表达，且与ＡＬ类型、病情及耐药有关，联合检测基因蛋白更有助于对化疗效果的预测。克服ｂｃｌ－２所致的耐药应设法下调ｂｃｌ－２的表达 To investigate the expression of bcl-2 and p53 protein in acute leukemia (AL) cells, their relationship and tolerance to chemotherapeutic agents, immunohistochemistry was used to detect the positive levels of bcl-2 and p53 protein. Apoptosis was used as an index to observe the tolerance of bcl-2 protein and AL to DNR. RESULTS: The positive rates of p53 and bcl-2 protein in 46 AL cells were 217% and 630%, respectively (P>005), which was related to cell type and condition. The positive rate of bcl-2 was more in the resistant group than in the relieving group (88.5%, 35.0%, P<0. 01). Eight of the two proteins were positive and the remission rate was 11/13. One of the low expression of bcl-2 AL cells and DNR (10 mg/L) had significant apoptosis, 4 Cases of high expression increased drug doses occurred. The results suggest that adult AL cells have abnormal expression of bcl-2 and p53 proteins, and are associated with AL type, disease state, and drug resistance. Combined detection of gene proteins is more helpful to predict the effect of chemotherapy. To overcome the resistance caused by bcl-2 should try to down-regulate the expression of bcl-2