Expression And Significance Of MCM2, Ki-67 And Survivin Protein In Childhood Acute Lymphoblastic Leukemia

Objective To study the expression of minichromosome maintenance protein 2, nuclei proliferation index Ki-67 and Inhibitor of apoptosis protein Survivin, as well as their relationship in childhood Acute lymphoblastic leukemia(ALL), in order to provid guidance for diagnosis, treatment and judging prognosis of childhood ALLMethods Bone marrow of 52 ALL children was collected as the experimental group; Bone marrow of 52 ALL children after standard chemotherapy for 19 days was the therapeutic group; and the control group was 20 children without malignant hematopathy. Immunization histiocyte cytochemical methods was used to determine the expression of MCM2, Ki-67 and Survivin. All of their clinical data was collected for statistical analysis.Results(1) The labelling index (LI) of MCM2, Ki-67 and Survivin in experimental group was significantly higher than that of in therapeutic group and control group(P<0.01). But there was no differences between therapeutic group and control group(P> 0.05).(2) The LI of MCM2 was significantly higher than that of Ki-67 and Survivin in experimental group(P<0.05), however the LI between Ki-67 and Survivin in experimental group had no differences (P>0.05). The LI of MCM2 had no differences with Ki-67 and Survivin in therapeutic group and control group, respectively(P>0.05).(3) The LI of MCM2 in high-risk ALL(HR-ALL) was higher than that of in middle-risk ALL(MR-ALL) and low-risk ALL(LR-ALL)(P< 0.01), and the LI of MCM2 in MR-ALL was higher than that of in LR-ALL(P<0.01). The LI of Ki-67 in HR-ALL was higher than that of in LR-ALL(P<0.05), and the LI of Ki-67 in MR-ALL was higher than that of in LR-ALL (P<0.05), but the LI of Ki-67 had no differences between HR-ALL and MR-ALL(P>0.05). The LI of Survivin in HR-ALL was higher than that of in LR-ALL(P<0.01), but the LI of Survivin had no differences between HR-ALL and MR-ALL(P>0.05), and also between MR-ALL and LR-ALL (P>0.05).(4) The LI of MCM2 was significantly higher than that of Ki-67 and Survivin whatever in HR-ALL, MR-ALL or LR-ALL(P<0.01). But there was no differences between Ki-67 and Survivin whatever in HR-ALL, MR-ALL or LR-ALL(P>0.05).(5) The LI of MCM2 had no correlation with age, sex and immunophenotype (P>0.05), but the LI of MCM2 was well positively correlated to initial WBC counts (P<0.01). The LI of Ki-67 and Survivin had no correlation with age, sex, initial WBC counts and immunophenotype (P>0.05).(6) The proportion of complete remission(CR) in MCM2 negative group was higher than that of in MCM2 positive group(P<0.05). The proportion of CR had no significant differences between negative group and positive group of Ki-67 and Survivin(P>0.05).(7) The LI of MCM2 in non-remission(NR) group was higher than that of in CR-group(P<0.01). The LI of Ki-67 and Survivin had no significant differences between NR-group and CR-group(P>0.05).(8) The expressions of MCM2, Ki-67 and Survivin in experimental group had correlated with each other positively(P<0.01).Conclusions(1) MCM2 protein may be an independent indicator for poor progno-sis in childhood ALL, and may be a reliable marker of cell proliferation.(2) MCM2 protein may play an important role in guidance of diagnosis, treatment and prognosis in childhood ALL, which was better than Ki-67 and Survivin protein.