儿童急性白血病初治患者LRP和MRP的表达及其临床意义

Expression of Lung Resistance Protein and Multidrug Resistance-associated Protein in Naive Childhood Acute Leukemia and Their Clinical Significance

背景与目的:有研究发现肺耐药相关蛋白(lungresistanceprotein,LRP)和多药耐药相关蛋白(multidrugresistance鄄associatedporotein,MRP)的表达与白血病患儿耐药有关,而且患儿耐药不是由于一种耐药机制引起的。本研究旨在观察LRP和MRP在不同类型小儿白血病初治时的表达情况及其与临床疗效的关系。方法:应用逆转录鄄聚合酶链反应法(RT鄄PCR)检测38例不同类型儿童急性白血病[27例急性淋巴细胞白血病(acutelymphoblastic,ALL),11例急性非淋巴细胞白血病(acutenonlymphocyticleukemia,ANLL)]及6名正常儿童LRP、MRP基因的表达,结合患儿化疗后的完全缓解(CR)率分析两种基因表达的意义。结果:38例患儿化疗后CR26例(68.4%)。38例患儿中LRP基因表达阳性11例(28.9%),表达阴性27例(71.1%),6例正常对照儿童LRP基因阴性。LRP基因阳性患儿的CR率低于阴性者(分别为27.3%和85.2%,P<0.05)。MRP阳性者21例,6例正常对照儿童MRP基因阴性。MRP基因阳性者的CR率低于阴性者(分别为47.6%和94.1%,P<0.05)。27例ALL患儿中LRP阳性5例,11例ANLL患儿中LRP阳性6例(分别为18.5%和54.5%,P<0.05)。27例ALL患儿中MRP阳性16例;11例ANLL患儿MRP阳性5例(分别为59.3%和45.5%,P>0.05),ALL和ANLL中MRP的表达无显著性差异。LRP基因阳性患者的MRP阳性率与LRP阴性者MRP阳性率无显著性差异(分别为28.6%和29.4%,P>0.05),说明LRP基因与MRP基因之间无相关性。结论:LRP基因及MRP基因阳性儿童急性白血病者病情重、化疗缓解率低,儿童ANLL相对于ALL化疗缓解率低可能与LRP的表达有关。

BACKGROUND ＆ OBJECTIVE： Previous studies revealed that lung resistance protein （LRP） and multidrug resistance-associated protein（MRP） relate to drug resistance of childhood leukemia, which is not caused by only one mechanism. This study was to evaluate the expression of LRP and MRP genes in childhood leukemia and their correlation. METHODS. The expression of LRP and MRP in 38 children with acute leukemia and 6 healthy children were measured with reverse transcription-polymerase chain reaction（RT-PCR）; their clinical significance was analyzed according to complete remission （CR） rate of the patients after chemotherapy. RESULTS： CR rate of the 38 patients was 68.4%. LRP was expressed in 11 of the 38 patients,and didn＇t express in healthy controls; CR rate was significantly lower in LRP-positive patients than in LRP-negative patients （27.3% vs. 85.2%, P 〈 0.05）.MRP was overexpressed in 21 of the 38 patients; CR rate was significantly lower in MRP-positive patients than in MRP-negative patients （47.6% vs.94.1%, P〈 0.05）. The positive rate of LRP was significantly lower in acute lymphoblastic leukemia （ALL） than in acute nonlymphocytic leukemia （ANLL）[18.5% （5/27） vs. 45.5% （6/11）, P〈 0.05]; however, the positive rate of MRP was 59.3% （16/27） in ALL, and 45.5% （5/11） in ANLL （P〉0.05）. The positive rate of MRP was 28.6% in LRP-positive patients, and 29.4% in LRP-negative patients; there was no correlation between LRP and MRP.CONCLUSION. Childhood acute leukemia patients with overexpression of LRP and MRP suffer severe disease and achieve low remission rate; lower remission rate of childhood ANLL patients may relate to LRP expression.