初治急性白血病多药耐药基因表达水平的定量开究

Quantitative Analysis of MDR 1 Gene Expression in De NOVO Acute Leukemic Patients

为了建立一种稳定可靠的多药耐药基因（ＭＤＲ１）ｍＲＮＡ检测方法，探讨ＭＤＲ１基因表达检测的临床价值，我们采用ＲＴ－ＰＣＲ１方法定量检测了Ｋ５６２、Ｋ５６２／ＡＤＭ细胞株和３０例初治急性白血病ＭＤＲ１的表达水平。结果发现：１）耐药Ｋ５６２／ＡＤＭ１细胞系的ＭＤＲ１表达较高，而Ｋ５６２敏感细胞系无表达。２）初治急性白血病患者ＭＤＲ１阳性表达率４０．０％，表达值为０．２２０８±０．０８９６。３）５例正常人对照均无ＭＤＲ１阳性表达。４）初治急性白血病ＭＤＲ１阳性表达组缓解率为４１．７％，明显低于阴性组８８．９％（Ｐ＜０．０１）。我们认为ＲＴ－ＰＣＲ是一种敏感性高、特异性强、可定量检测ＭＤＲ１表达手段，有临床实用价值；另外，初治急性白血病患者ＭＤＲ１表达检测的结果表明，ＭＤＲ１表达增加是化疗的一个不利因素，且对化疗方案的选择有一定的指导意义。

To evaluate the clinical value of the expression of multidrug resistance gene(MDR1) on acute leukemia and to select a reliable quantitative method of expression of MDR1,we analyzed the expression levles of MDR1 in drug-sensitive K562 cell line and multidrug-resisant K562/ADM cell line with RT-PCR. 30 adultuntreated patients were studied by the same tehnique.The results showed that there were a higher lever of MDR1 gene expression in K562/ADM resistant cell line and an undetectable level in K562 sensitive cell line.The MDR1 mRNA positive rates in 30 untreated eases and 5 normal cases were 40. 0% and 0% respectively. All Patients were treated by standard chemotherapy.Complete remission rates were significantly lower in MDR1 mRNA positive group than negative group(41、 7% v 88. 9%P<0. 01). It is conclude that RT-PCR methd is a sensitive quantitation tool for expression of MDR1 and can be used in clinical patients. These data also indicate that MDR1 mRNA expression is an infavorable prognostic factor on diagnosis in acute leukemia and suggest that the levels ofMDR1 mRNA have clinical significance to select the induction chemotherapy regimens.