Research On The Expression And Clinical Significance Of Inhibitor Of Apoptosis Protein, Survivin, In Leukemia

Objective To investigate the clinical significance and the relation of the expression of Surviving protein with the therapeutic effect and the feasibility of testing the expression of Surviving protein in leukemia bone marrow qualified by detecting the positive rate and values of a bone marrow apoptosis protein,Survivin,in leukemic bone marrow smears or leukemic cell cytospins.Methods The immunohistochemical stain was used to detect the positive rate and the values of Survivin protein,in leukemic bone marrow smears and leukemic cell cytospins.The expression of Survivin protein was measured in acute leukemia(AL) and chronic myeloid leukemia(CML) patients when they were untreated,complete remission (CR) or relased.Results The positive rate and the values of Survivin protein in newly diagnosed acute leukemia(AL) were significantly increased compaired with normal control(NC). While it decreased in complete remission(CR) patients.There was significant difference of the positive expression rates expression of Survivin protein between AL and NC(p＜0.01).and there was no difference of the expression between CR patients and NC(p＞0.05).In replased AL patients,the expression of Survivin protein increased significantly again and there was significant difference of the positive expression rates of Survivin between replased patients and NC but no difference between replased patients and newly diagnosed AL(p＞0.05).There was no difference of the positive expression rates of Survivin among different type of AL(p＞0.05).There was no difference of the expression between chronic phase of CML and NC(p＞0.05),but the expression was higher than that in NC(p＜0.01 ) in acute phase of CML.There was no difference of the positive expression of Survivin protein between leukemia bone marrow smears and leukemia cell cytospins(p＞0.05).Conclusion The expression of Survivin protein was significantly increased in newly diagnosed leukemia and relapsed patients while decreased in patients in CR.It indicates that apoptosis inhibition plays an important role in leukemia.There were no difference of the positive rate of Survivin protein expression among different type of acute leukemia.It implys the expression of Survivin protein did not associate with cell category.The expression of Survivin protein was lower in chronic phase of CML patients,while increased significantly in CR patients.It indicates that the expression of Survivin protein was related to hematopoietic cell differentiation.Overexpression of Survivin protein maybe a risk factor of CML in acute phase.In AL patients,the CR rate of Survivin positive cases was lower than that of negative cases indicating that positive expression of Survivin can serve as a marker of poor prognosis in AL.Dynamic detection of Survivin protein expression in bone marrow leukemic cells may serve as an important marker of progression,therapeutic effect and prognosis in leukemia.There was no difference between leukemia bone marrow smears and leukemic cell cytospins so we can directly test the positive expression of Survivin in leukemia bone marrow smears in our clinical work.