P-gp和细胞表面分化抗原在ALL中表达的关系和临床意义

The Relationship and Clinical Significance between P-gp and Cell Surface Differentiation Antigens in Acute Lymphoblastic Leukemia

目的探讨初治急性淋巴细胞白血病(ALL)中P-糖蛋白(P-gp)与细胞表面分化抗原表达的关系及意义。方法应用流式细胞术对64例初治ALL患者进行P-gp及免疫表型的检测。结果 P-gp的阳性表达率为45.3%,CD34为59.4%,My+ALL为31.3%,其中CD13阳性率最高,为20.3%。P-gp与预后呈负相关(P<0.05),CD34+、My+ALL与CD34-、My-ALL的CR率差异均无统计学意义(P>0.05)。P-gp+组中CD34的表达显著高于P-gp-组(P<0.05),其他中晚期抗原表达差异无统计学意义。P-gp与CD34协同表达则CR率更低(52.2%vs90.0%)。结论 P-gp的表达在初治ALL患者中具有重要的预后意义。P-gp的过度表达与CD34有关,P-gp+/CD34+的ALL属于一种预后不良的临床亚型。

Objective To explore the relationship and significance between P-glycoprotein and cell surface differentiation antigens in ALL.Methods FCM was used to detect the expression of P-glycoprotein and immunophenotype in 64 de novo ALL patients.Results The positive rates of P-gp,CD34 and Ly＋ were 45.3%,59.4% and 31.3%,respectirely.Compared to other surface antigens,CD13（20.3%） was the common one in My＋ ALL.P-gp was negative correlation with prognosis in ALL（P0.05）.No statistical difference in the CR rates were found between CD34＋,My＋ ALL and CD34-,My-ALL（P0.05）.The positive rate of CD34 in P-gp＋ patients was higher than that in P-gp patients（P0.05）.The CR rate in P-gp＋/CD34＋ patients was lower than that in P-gp-/CD34-patients（52.2% vs 90.0%）.Conclusions It is suggested that the expression of P-gp possesses prognostic significance in ALL.The overexpression of Pgp is related to CD34 and ALL patients with P-gp＋/CD34＋ predicts a poor prognosis.