Fas和mdr-1在急性白血病的表达及其相关性研究

Clinical Studies on Expressions of Fas and mdr-1 in Acute Leukemia and Their Correlations

本研究应用流式细胞仪 (FCM)直接免疫荧光法和半定量RT PCR方法分别测定 5 9例初发急性白血病(AL)患者治疗前及完全缓解 (completeremission ,CR)后骨髓Fas和mdr 1mRNA表达情况 ,旨在探讨Fas和mdr 1在AL的表达及二者在多药耐药 (multidrugresistance ,MDR)中的相关性。结果显示 :Fas在初发AML阳性表达率比ALL高 ,两表达率间有差异 (P <0 .0 5 ) ,mdr 1在AML和ALL阳性表达率间无差异 (P >0 .0 5 ) ,Fas+ 与mdr 1+ 有负相关性 (r =- 0 .2 82 ,P <0 .0 5 ) ;经单因素及多因素COX分析 ,Fas和mdr 1独立于其他参数 ,更具判断预后价值 ;在Fas+ 与Fas-的AML和AL ,CR率均有显著性差异 (P <0 .0 1) ,在mdr 1+ 、mdr 1-的AML和AL中的CR率有显著性差异 (P <0 .0 1) ;经Logrank检验 ,Fas+ 与Fas-组CR率及中数缓解时间有显著性差异 (χ2 =7.35 ,P =0 .0 0 6 7) ,mdr 1+ 与mdr 1-组CR率及中数缓解时间有显著性差异 (χ2 =10 .71,P =0 .0 0 11)。结论 :Fas、mdr 1与疗效高度相关 ;Fas阳性表达可能是AL预后良好因素 ;mdr 1为疗效差、预后不良的重要因素。

To explore the Fas and mdr-1 expression and their correlation in multidrug resistance (MDR),Fas and mdr-1 expressions of bone marrow from 59 patients with newly diagnosed AL before therapy and after complete remission were detected by direct immunofluorescance with flow cytometry and semi-quantitative RT-PCR,respectively. The results showed that in newly diagnosed AL patients,Fas expression in AML was higher than in ALL (P<0.05),mdr-1 expression in AML and ALL had no difference (P>0.05),the expressions of Fas and mdr-1 had correlation (r= -0 282 ,P<0.05) in AL;the resultes of simple-variable and multivariable COX survival factor model analysis suggested that Fas and mdr-1 expressions were prognostic factors for the effect of therapy and survival. Log rank test,comparing the groups of Fas +with Fas -,mdr-1 + with mdr-1 -,demonstrated that the CR rates and median remission time of every two groups had significant difference. It is concluded that in AL,Fas and mdr-1 expressions have high correlation with the effect of treatment,Fas expression probably is one of the favorable prognostic factors,mdr-1 is an unfavorable prognostic and less effective factor.