肺耐药相关蛋白的表达及MTT检测在造血系统恶性肿瘤中的临床意义

THE CLINICAL SIGNIFICIANCE OF LUNG RESISTANCE PROTEIN(LRP) EXPRESSION IN PATIENTS WITH MALIGNANT TUMOR IN HEMATOLOGY AND MTT ASSAY

目的:探讨肺耐药相关蛋白(lung resistance protein,LRP)在造血系统恶性肿瘤中的表达与临床耐药的关系。方法:应用流式细胞术(flow cytometry,FCM)检测43例造血系统恶性肿瘤患者及38例普通血液病患者LRP的表达,同时应用MTT法测定20例患者对9种化疗药物的敏感性。结果:初治组LRP的阳性率为65.52 %;复发组为83.33 %;缓解组为37.50 %;对照组为31.58 %。初治组与对照组比较差异有显著性(P<0.01);复发组与对照组比较有显著性差异(P<0.05)。初治组+复发组总阳性率68.57 %与对照组比较差异有显著性(P<0.01)。LRP阳性与LRP阴性患者的首次完全缓解率(CR1)分别为38.46 %和85.71 %,两者的差异有显著性(P<0.05);体外药敏检测与治疗疗效有相关性,临床总符合率为75 %,阳性符合率为100 %,阴性符合率为66.67 %。结论:LRP是一个有效的化疗耐药指标;LRP高表达可导致临床耐药;同时将LRP的表达和体外化疗药物敏感性的检测作为耐药指标观察,对提高临床耐药判断的准确性,指导临床化疗方案的设计有积极的意义。

Objective: To investigate the relationship between the expression of lung resistance protein (LRP) and drug resistance in patients with malignant tumor in hematology. Methods: Flow cytometry was used to examine the expression of LRP in 43 patients with malignant tumor in hematology and 38 patients with non- malignant tumor in hematology. Meanwhile, the malignant tumor cells to 9 anti-tumor drugs was estimated in 20 patients with malignant tumor in hematology by MTT assay. Results: The positivity percentage of LRP expression in newly diagnosed group was 65.52 %; The first complete remission rate was 38.46 %和85.71 %, in LRP positive and LRP negtive patients, respectively. The difference was significant (P <0.01)The expression of LRP and the positivity percentage of LRP in relapsed group and in newly diagnosed group were significantly higher than that in non-malignant tumor in hematology,respectively(P <0.01 and P <0.05).As well as the difference was significant between the total of the positivity percentage of LRP in relapsed group and in newly diagnosed group and subjective group(P <0.01). The results of the study reveals that the chemosensitivity assay correlated well with the outcome of the treatment with overall predictive rate of 75 %, a positive predictive rate of 100 % and a negtive predictive rate of 66.67 %, respectively. Conclusion: LRP expression was found to be an useful parameter to predict the outcome of the treatment.High expression of LRP leads to clinical drug resistance.