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目的探讨ｂｃｌ２基因表达在慢性粒细胞白血病（ＣＭＬ）急变中的生物学意义。方法采用碱性磷酸酶抗碱性磷酸酶免疫复合物方法和地高辛标记探针原位杂交技术检测各期ＣＭＬ患者６０例新鲜骨髓标本中ＢＣＬ２蛋白和ｂｃｌ２ｍＲＮＡ的表达，并对其中１９例标本进行流式细胞术分析骨髓细胞凋亡率及细胞周期。结果初诊和治疗后ＣＭＬ中ｂｃｌ２基因表达相近，但明显低于急变时。ｂｃｌ２ｍＲＮＡ表达与蛋白表达基本一致。ｂｃｌ２基因高表达与ＣＭＬ患者外周血血红蛋白、血小板、幼稚细胞及骨髓不成熟细胞比例相关。加速／急变期ＣＭＬ细胞凋亡率明显低于慢性期，但细胞周期无明显变化。结论ＣＭＬ急变时ｂｃｌ２基因表达增高，骨髓细胞凋亡率降低，这些现象部分地阐明了ＣＭＬ急变预后不良的机制，也为ＣＭＬ急变的早期诊断和治疗提供了实验依据。
Objective To investigate the biological significance of bcl2 gene expression in the rapid change of chronic myelogenous leukemia (CML). Methods The expression of BCL2 protein and bcl2 mRNA in fresh bone marrow samples of 60 patients with CML were detected by alkaline phosphatase anti alkaline phosphatase immune complex method and digoxigenin labeled probe in situ hybridization. Among them, 19 samples were subjected to flow cytometry to analyze the apoptosis rate and cell cycle of bone marrow cells. Results The expression of bcl2 gene in CML was similar between the initial diagnosis and treatment, but it was significantly lower than that of rapid change. Bcl 2 mRNA expression and protein expression were basically the same. The high expression of bcl2 gene is related to the proportion of hemoglobin, platelets, immature cells and immature bone marrow cells in peripheral blood of CML patients. The rate of apoptosis in CML cells was significantly lower than that in the chronic phase in accelerated/failure stage, but there was no significant change in cell cycle. Conclusion The expression of bcl2 gene is increased and the apoptosis rate of bone marrow cells is decreased in CML blast crisis. These phenomena partly elucidate the mechanism of the poor prognosis of CML, and provide experimental basis for the early diagnosis and treatment of CML rapid changes.