P-gp在急性淋巴细胞白血病中的表达及临床意义

Expression and clinical significance of P-gp in acute lymphoblastic leukemia

目的探讨P-糖蛋白(P-gp)在急性淋巴细胞白血病的表达,评估P-gp与急性淋巴细胞白血病预后的关系。方法用流式细胞仪,采用直接免疫荧光法,检测40例急性淋巴细胞白血病患者抗P-gp单克隆抗体UIC2及CD3、CD5、CD7、CD10、CD19、CD13、CD14、CD33、CD34的表达,被检患者外周血或骨髓中幼稚细胞数≥50%,并设非耐药细胞系K562为阴性对照。结果40例ALL患者中16例P-gp表达阳性,P-gp阳性表达率为40%。髓系抗原表达阳性者P-gp阳性率为33.3%,髓系抗原表达阴性者P-gp阳性率为45.5%,P>0.05。4例急性T淋巴细胞白血病CD7表达阳性,且P-gp表达皆阳性。P-gp阳性组16例患者中10例治疗有效,P-gp阴性组24例中20例治疗有效,P-gp表达阳性者中3例6个月内复发。结论急性淋巴细胞白血病P-gp阳性表达率为40%;P-gp表达与髓系抗原表达无相关性,与CD7表达有关;P-gp表达阳性与急性淋巴细胞白血病化疗效果有相关性,P-gp表达阳性者易早期复发。

Objective To detect the expression of P-glycoprotein （P-gp） in acute lymphoblasticleukemia （ALL） and evaluate the relationship between P-gp expression and prognosis of ALL. Methods The expression of anti-glycoprotein monoantibody： UIC2 and CD3, CDS, CD7, CD10, CD19, CD13, CD14, CD33, CD34 in 40 patients was defected with direct immunofluorescence assays by Flow Cytometry. The leukemia cells in peripheral blood and bone marrow should be more than fifty percent. The cell lineage of non-drug resistance, K562, was used as negative control. Results Sixteen patients in 40 expressed P-gp. P-gp positive rate in myeloid antigen positive cases was 33.3%. P-gp positive rate in myeloid antigen negative cases was 45.5%, P 〉 0.05. Four cases of T-cell acute lymphoblastic leukemia expressed CD7 and P-gp at the same time.Treatment was effective in ten of sixteen cases in P-gp positive group and effective in 20 of 24 cases in P-gp negative group （ P 〉 0.05）, while six cases in P-gp positive cases relapsed in six months. Conclusion P-gp positive rate in ALL is 40%. There is not relationship between expression of P-gp and myeloid antigens. The P-gp expression correlates with the CD7 expression. The P-gp expression correlates with chemotherapeutic effect in ALL P-gp positive cases are prone to relapsing earlier.