急性白血病P-糖蛋白表达检测及临床意义  

Expression of P-glycoprotein in Acute Myeloid and Lymphoblastic Leukemia: Correlation with Induction Treatment Outcome

作　　者：庄静丽[1] 徐建民[1] 王宝珍[1] 吴直江[2] 高奇蓉[2] 

机构地区：[1]复旦大学附属中山医院血液科,上海200032 [2]中科院上海生化细胞所,上海200031

出　　处：《中国临床医学》2004年第5期805-807,共3页Chinese Journal of Clinical Medicine

摘　　要：目的 :检测P -糖蛋白 (P - gp)在急性髓系白血病 (AML)和急性淋巴细胞白血病 (ALL)不同分组的表达率 ,分析阳性表达与诱导缓解率的相关性。方法 :72例急性白血病患者骨髓标本 :初治组 18例 ,完全缓解 (CR)组 38例 ,复发组 16例。用单克隆抗体和流式细胞仪检测 72例患者骨髓单个核细胞P -gp表达率。分析P - gp表达在不同分组之间有无差异及阳性表达与诱导化疗CR率的关系。结果 :1)P - gp总表达率 34.72 % ,初治组、CR组和复发组分别是 2 2 .2 2 %、2 3.6 8%和 75 %。复发组P - gp表达率明显高于初治组和CR组 (P =0 .0 0 2 1,P =0 .0 0 0 4 1) ;初治组与CR组之间无显著差异 (P =0 .90 )。 2 )P - gp在ALL组和AML表达率分别是 33.3%和 35 .70 % ,两组无显著差异 (P =0 .5 7)。 3)P - gp表达阳性组与阴性组CR率分别是 4 0 .0 0 %和 80 .85 % ,有显著差异 (P =0 .0 0 0 4 6 )。结论 :1)P - gp表达率在复发组显著高于初治和CR组。 2 )P -gp表达率在ALL和ANLL无显著差异。 3)P -gp表达阳性与CR率低相关 ,是AML和ALL化疗耐药的预测指标。Objective: To assay the expression of P-gp in acute myeloid leukemia(AML) and acute lymphoblastic leukemia(ALL) and estimate if the expression of these proteins can be used as an index of drug resistance. Methods: 72 cases of acute myeloid and lymphoblastic leukemia were divided into three groups: new treatment group (18 cases), complete remission group (CR, 38cases) and relapse group (16 cases). the expression of P-gp in acute myeloid and lymphoblastic leukemia was detected by flow cytomentry and monoclonal antibody assays the relationship between positive expression rates and CR rates was anagzed. Results: 1) The positive rate of P-gp expression were 22.22%?23.68% and 75.00%, repectively. 2) Positive expression of P-gp in ALL and AML were 33.3%和35.70%. 3) Rates of complete remission between positive and negative expression of P-gp were 28.00% vs 82.98%. Conclusion:Our result demonstrated that P-gp protein was more expressed in relapse group, positive expression of P-gp protein was significantly associated with a lower CR rate. Positive expression of P-gp protein is an independent prognostic factor for multidrug resistance in adult acute leukemia.

关 键 词：P-GP 初治 表达率 CR 复发 P-糖蛋白 急性白血病 目的 差异 相关性 

分 类 号：R733[医药卫生—肿瘤] R735[医药卫生—临床医学]