急性白血病患者lrp、mdr-1/p170和mrp表达及其临床意义  

The clinical significance of lung resistance related protein gene (lrp), multidrug resistance associated protein gene (mrp) and mdr 1/p170 expression in acute leukemia

作　　者：赵瑜[1] 于力[1] 楼方定[1] 王全顺[1] 浦津[1] 周绮[1] 

机构地区：[1]解放军总医院血液科,北京100853

出　　处：《中华内科杂志》1999年第11期760-763,共4页Chinese Journal of Internal Medicine

基　　金：军队"九五"攻关课题基金

摘　　要：目的　评价肺耐药相关蛋白基因（ｌｒｐ） 、多药耐药相关蛋白基因（ｍｒｐ） 和多药耐药基因（ｍｄｒ１）及其编码的ｐ１７０ 蛋白表达与急性白血病患者多药耐药（ＭＤＲ）的关系。方法　将８５ 例急性白血病患者分为初治敏感（Ａ） 、完全缓解（Ｂ）和复发难治（Ｃ） 组，用逆转录聚合酶链反应（ＲＴＰＣＲ） 法检测患者骨髓单个核细胞中ｌｒｐ 、ｍｒｐ 和ｍｄｒ１ 的ｍＲＮＡ 表达，同时用免疫细胞化学方法检测ｐ１７０ 表达。结果　（１）ｌｒｐ 基因表达在急性非淋巴细胞白血病（ＡＮＬＬ） Ａ、Ｂ、Ｃ 三组阳性表达分别为１１．１１％ 、９－０９％ 、３６．３６％ ； 在急性淋巴细胞白血病（ＡＬＬ）Ａ、Ｂ、Ｃ三组阳性表达分别为０％ 、２０ ．００％ 、４６ ．６７％ 。（２）ｍｒｐ 在ＡＮＬＬ中Ａ、Ｂ、Ｃ三组阳性表达分别为４４ ．４４％ 、９．０９％ 、５９．０９％ ； 在ＡＬＬ中Ａ、Ｂ、Ｃ三组阳性表达分别为２８．５７％ 、２０．００％ 、５３．３３％ ；（３）ｍｄｒ１ 在ＡＮＬＬ 中Ａ、Ｂ、Ｃ 三组阳性表达分别为０％ 、４－５４％ 、５９．０９ ％ ， 在ＡＬＬＡ、Ｂ、Ｃ三组阳性表达分别为０％ 、０％ 、３３．３３％ ；（４）ｐ１７０ 在ＡＮＬＬ复发难治组表达（９－Objective To evaluate the relationship between lrp, mrp , mdr 1/p170 and multidrug resistance in acute lukemia (AL). Methods 85 AL patients were divided into three groups: untreated (A)、complete remisson (B) and relapsed/refractory (C). The expression of lrp、mrp and mdr 1 mRNA was detected with RT PCR assay and that of p170 measured with immunocytochemistry. Results The frequency of lrp gene expression in ANLL A,B and C group was 11.11%,9.09% and 36.36%, in ALL A,B,C group it was 0%, 20.00% and 46.67%; the frequency of mrp gene expression in ANLL A,B,C group was 44.44%,9.09% and 59.09%, in ALL A、B、C group it was 28.57%,20.00% and 53. 33%; the frequency of mdr 1 gene expression in ANLL A,B,C group was 0%, 4.54% and 59.09%, in ALL A、B、C group it was 0%,0% and 33.33%; p170 expression in ANLL C group was (9.45±14.66) %, it was the highest value in the three groups; statistics showed that there was no correlationship among the expressions of lrp,mrp and mdr 1 gene, P >0.05; patients with lrp and mdr 1 expression had a lower complete remission (CR) percentage than those who had not in the untreated group; the combination of lrp, mrp and mdr 1 gene detection turned out to be a more sensitive, specific and accurate way in evaluation of multidrug resistance (MDR). Conclusion Overexpression of one or more genes of lrp, mrp and mdr 1/p170 is associated with MDR in AL. Expression of lrp, mrp and mdr 1/p170 is good indicators in clinical MDR. Two or three factors of lrp, mrp and mdr 1 are more valuable in the evaluation of MDR than any one of these three factors. The mechanisms of mrp,lrp and mdr 1 causing MDR are different, it means that the mechanisms of MDR are complicated the combination of lrp ,mrp and mdr 1/p170 detection may be the best way to evaluate MDR.

关 键 词：白血病 急性 肺耐药 相关蛋白 MDR-1 P170蛋白 

分 类 号：R733.710.2[医药卫生—肿瘤]