急性白血病患者mdr-1基因与P-gp糖蛋白表达

CORRELATION STUDY ON EXPRESSION OF MULTIDRUG RESISTANCEGENE AND PGLYCOPROTEIN IN PATIENTS WITH ACUTE LEUKEMIA

目的：评价ｍｄｒ１基因与Ｐｇｐ糖蛋白在急性血病（ＡＬ）细胞中表达的相关性及其临床意义。方法：分别应用ＲＴＰＣＲ及流式细胞术（ＦＣＭ）检测３２例ＡＬ患者白血病细胞中的ｍｄｒ１ｍＲＮＡ及Ｐｇｐ糖蛋白表达率及表达水平，同时检测１４例正常人作为对照。结果：临床非耐药组ｍｄｒ１阳性率为２２．２％，Ｐｇｐ阳性率为３３．３％，而临床耐药组两者分别为７８．６％、８５．７％，均与临床治疗结果有极显著的一致性（Ｐ＜０．００５和Ｐ＜０．０１）。ｍｄｒ１＋／Ｐｇｐ＋的１３例患者中，１１例为临床耐药（８４．６％），其中１０例表现为ｍｄｒ１＋／Ｐｇｐ＋结果为中高度表达，临床非耐药的２例患者，ｍｄｒ１＋／Ｐｇｐ＋都是低度表达。相关性检验显示两方法有极显著的一致性。结论：ｍｄｒ１与Ｐｇｐ均可预测ＭＤＲ，同时检测ｍｄｒ１／Ｐｇｐ可提高ＭＤＲ检出符合率。

Objective:To study the relationship between multidrug resistance gene(mdr1) and Pglycoprotein(Pgp) in acute leukemic cells and evaluate their clinical significance.Methods:The expression levels of mdr1 mRNA and Pgp were studied by reverse transcription ploymerase chain reaction(RTPCR) and flow cytometry method(FCM) respectively in 32 cases of acute leukemia and 14 normal controls.Results:The mdr1 and Pgp positive rates were 22.2%,33.3% in clinical nonresistant group and 78.6%,85.7% in drugresistant group.The mdr1 and Pgp eapressions were in accordance with the results of clinical chemotherapy.Among 13 cases of acute leukemia showing positive mdr1 and Pgp expression,11 cases displayed clinical drug resistance and 10 of these cases expressed mdr1 and Pgp at medium and high levels.Only two cases in the clinical nonresistant group expressed mdr1 and Pgp at a lower level.There was significant correlation between the two methods.Conclusion:Both FCM analysis of Pgp and RTPCR detection of mdr1 could predict the multidrug resistance(MDR) and the results of the two methods showed a good correlation.The diagnostic accordance rate of MDR can be raised while mdr1 and Pgp are detected at the same time.