多药耐药基因与体外药敏检测在急性白血病中的临床意义

The clinical significance of multidrug resistance gene expression and vitro chemosensitivity test in acute leukemia

目的:研究急性白血病(AL)多药耐药-1(MDR_1)基因表达与临床疗效的关系,提高对肿瘤细胞耐药情况预测的准确性.方法:采用逆转录酶-多聚酶链反应(RT-PCR)检测了30例AL患者骨髓中MDR_1基因的表达,同时对每例均进行体外化疗药物敏感性(MTT法)检则.结果:30例ALMDR_1基因过度表达占40%,MTT检出耐药为30%(10/30),既有MDR_1基因过量表达又显示耐药者为27%(8/30);体外药敏实验结果与疗效比较,总符合率为86%,阳性符合率85%,阴性符合率91%,MDR_1基因过度表达与临床疗效呈负相关.结论:同时进行这两种方法的检测能提高临床耐药判断的准确性,有利于合理选用化疗药物以提高疗效.

AIM: To investigate the relationship between the multidrug resistance-1 (MDR1) gene expression and the vitro chemosensitivity test in acute leukemia. METHODS: Quantitative reverse transcriptase polymerase chain reaction (RT-PCR) method and MTT assay were used to detect the multidrug resistance gene expression, and the sensitivity of leukemia cells to 8 kind of anti-tumor drugs in 30 patients with acute leukemia. RESULTS: MDR gene overexpression was 40%,while the drug resistance was 30% (10/30),MDR mR-NA+ Positive and the drug resistance were 27% (8/30). There was a good linear relationship between the MDR gene overexpression and the outcome of chemotherapy. The general,positive and negative coincident rates of chemosensitivity in vitro with those of in vivo sensitivity were 86% ,85%and 91% respectively. CONCLUSION: From this study,it is our impression that RT-PCR and the MTT assay gives a good correct, predictive value in acute leukemia chemotherapy.