中文摘要：

目的：探讨抗凋亡基因XIAP在慢性淋巴细胞白血病中的表达,分析其与IgVH突变、CD38等临床重要预后指标的相关性。方法：采用SyberGreen法实时定量PCR（qPCR）技术检测37例CLL患者肿瘤细胞中抗凋亡基因XIAP的mRNA表达水平,同时利用28例年龄匹配的正常人作为阴性对照,分析其临床意义。结果：经过qPCR检测正常对照组XIAP表达中位数为0.04040（95%CI：0.01610～0.06471）,CLL组XIAP表达为0.07502（0.04383～0.1062）,两者具有显著统计学差异（P=0.0025）;亚组分析发现耐药组XIAP表达为0.08295（0.02575～0.1402）,药物敏感组为0.07020（0.03042～0.1100）,耐药组XIAP表达高于药物敏感组,但是未达到统计学差异（P=0.3978）。进一步分析显示XIAP mRNA表达水平和IgVH突变状态和CD38表达相关：IgVH无突变和CD38高表达的CLL患者XIAP表达显著升高（P值分别为0.0265和0.0388）。结论：利用qPCR技术发现抗凋亡基因XIAP在CLL患者中存在异常高表达,耐药组有高于药物敏感组的趋势,并且与CLL临床预后因素IgVH突变状态和CD38表达密切相关。

英文摘要：

Objective： Several mechanisms were found in the chronic lymphocytic leukemia（CLL） cell apoptosis-resistant process.The objective of this study was to investigate expression of anti-apoptotic gene XIAP in CLL patients and its clinical association with established prognostic factors（IgVH mutation status and CD38 expression）.Methods： A total number of 37 CLL patients and 28 age-matched normal control were enrolled in this study.XIAP mRNA expression was detected by SyberGreen-based real-time PCR,clinical relationship was analyzed by GraphPad Prism software.Results：XIAP median expression was 0.04040（95% CI∶0.01610-0.06471） in CLL group compared to 0.07502（95% CI：0.04383-0.1062） in normal control group（P=0.0025）;further sub-groups analysis implicated that XIAP expression was higher in drug-resistant group than that in drug-sensitive without statistical difference（P=0.3978）,IgVH non-mutated status and positive CD38 expression were associated with higher XIAP expression.Conclusion：Abnormal XIAP mRNA expression as found in CLL patients with significant correlation with established prognostic factors and potential role in drug resistance,and XIAP may become a new supplement of CLL prognostic markers.