成人急性淋巴细胞白血病中乳腺癌耐药蛋白基因表达及其临床意义

Gene Expression of Breast Cancer Resistance Protein in Adult Acute Lymphocytic Leukemia and Its Clinical Significance

本研究探讨成人急性淋巴细胞白血病(ALL)患者乳腺癌耐药蛋白(BCRP)基因表达与临床耐药及预后的关系。应用半定量逆转录-聚合酶链反应(RT-PCR),以β2微球蛋白(β2-MG)作内对照,检测了97例初治敏感及难治耐药的ALL患者BCRP基因的表达,并检测30例正常人BCRP基因表达水平,将BCRP/β2-MG≥0.48定为BCRP阳性。结果显示:初治敏感ALL患者BCRP基因表达阳性率为28.7%,难治耐药BCRP基因表达阳性率为51.2%。BCRP阴性和阳性患者的首次完全缓解(CR1)率分别为71.7%和29.7%(p<0.01)。BCRP基因表达水平在ALL的FAB亚型间L3型明显高于L1、L2型;在免疫分型中B细胞性ALL患者BCRP基因表达较T细胞性高,存在着明显的统计学差异(p<0.01),尤其以成熟B细胞性ALL最高。结论:ALL患者的BCRP基因高表达可以导致临床耐药,是ALL患者不利的预后因素。

The objective of this study was to investigate the relationship between the expressions of breast cancer resistance protein （BCRP） gene and drug resistance as well as prognosis in adult patients with acute lymphocytic leukemia（ALL）. Semi-quantitative reverse transcriptase polymerase chain reaction （RT-PCR） was used to detect the expression of BCRP gene in 97 adult patients with acute lymphocytic leukemia （ALL） and 30 normal subjects. 132 mircoglobulin （β2-MG） was used as an internal reference. BCRP/β2-MG ratio.≥0.48 was defined as BCRP positive. The results showed that the positive ratio of BCRP gene expression in untreated group was 28, 7%, in contrast that in refactory and relapsed patients was 51.2%. The first complete remission rates in patients with negative and positive expression were 71.7% and 29.7% respectively. In ALL subtypes BCRP gene expression of L3 type was distinctly higher than that of Ll , L2 types. In immune types the BCRP gene expression of B-ALL was higher than that of T cell type,especially in mature B cell type with obviously statistical significance（p 〈 0.01 ）. It is concluded that the high expression of BCRP gene may induce clinical drug resistance, and may be an unfavorable factor for prognosis in adult patients with acute lymphocytic leukemia.