多药耐药蛋白P170在儿童初发急性白血病患者骨髓中的表达及意义

Expression and significance of multidrug resistance protein P170 in newly diagnosed childhood acute leukemia

目的检测儿童急性白血病初发时骨髓中多药耐药蛋白P170的表达,分析P170表达与患儿多药耐药的关系及临床意义。方法 66例儿童急性白血病患者中男性40例,女性26例;急性淋巴细胞性白血病(ALL)45例,急性非淋巴细胞性白血病(ANLL)21例;根据疗效分为初治敏感组(n=40)和难治耐药组(n=26)。采用流式细胞术检测骨髓细胞多药耐药蛋白P170的相对表达率,并分析P170表达阳性率与耐药性和性别间的关系。结果难治耐药组的急性白血病患儿P170表达阳性率显著高于初治敏感组(65.4%和37.5%,P<0.05);但ANLL组与ALL组、男性组与女性组的P170表达阳性率比较差异均无统计学意义(44.4%和57.1%,P>0.05;45.0%和46.2%,P>0.05)。结论儿童急性白血病患者初发时P170表达阳性者易产生多药耐药,预后可能较差;P170在儿童急性白血病的不同分型和性别间的表达无差异。

Objective To investigate the expression of multidrug resistance protein P170 in newly diagnosed childhood acute leukemia,explore the relationship between the expression of P170 and multidrug resistance and its clinical significance. Methods Sixty-six cases of childhood acute leukemia were collected,among whom 40 were male and 26 were female.Forty-five cases were acute lymphoblastic leukemia(ALL) and 21 cases were acute non-lymphocytic leukemia(ANLL).Patients were divided into complete remission group(n=40) and relapse group(n=26).The expression of multidrug resistance protein P170 in marrow cells was detected by flow cytometry,and the correlations of the expression of P170 with drug resistance and gender were analysed. Results The expression of P170 in relapse group was significantly higher than that in complete remission group(65.4% vs 37.5%,P<0.05),while there was no significant difference in the expression of P170 between ANLL group and ALL group(44.4% vs 57.1%,P>0.05) and between male group and female group(45.0% vs 46.2%,P>0.05). Conclusion The expression of P170 in newly diagnosed childhood acute leukemia is likely to result in multidrug resistance and negative prognosis.There is no significant difference in the expression of P170 between different disease types and different genders in childhood acute leukemia.