急性淋巴细胞白血病患儿肺耐药蛋白表达及临床意义

Lung resistance-related protein expression in childhood patients with acute lymphocytic leukemia and its clinical significance

应用免疫组化法 ,对 2 7例初治和 2 1例复发及难治的急性淋巴细胞白血病 (AL L )患儿检测外周血或骨髓中白血病细胞的肺耐药蛋白 (L RP)表达情况 ,同时体外应用 MTT方法观察了所有患儿的白血病细胞对柔红霉素 (DNR)化疗的敏感性。结果 :2 7例初治患儿的 L RP表达率为 18.5 % ,2 1例复发及难治患儿的 L RP表达率为 6 6 .7% ,两者比较 P<0 .0 1。在 2 7例初治患儿组中 ,L RP表达阴性者对 DNR的敏感率为 86 .4 % ,L RP表达阳性者为 2 0 % ,两者比较 P<0 .0 1;在 2 1例复发及难治患儿中 ,L RP表达阴性者对 DNR敏感率为 2 8.6 % ,L RP表达阳性者为 2 1.4 % ,两者比较 P>0 .0 5。在 2 7例初治组患儿中 ,L RP表达阴性者的 CR率为 90 .9% ,L RP表达阳性者为 6 0 % ,两者比较 P<0 .0 1;在 2 1例复发及难治患儿中 ,L RP表达阴性者的 CR率为 4 2 .9% ,L RP表达阳性者为 5 0 % ,两者比较 P>0 .0 5。认为 L RP可能是产生多药耐药 (MDR)

Lung resistance related protein(LRP)expression was detected in periphral blood or bone marrow leukemia cells from 27 untreated patients and 21 relapsed refractory childhood patients with acute lymphocytic leukemia(ALL)by immunohistochemistry In same time the chemosensitivity of leukemia cells to DNR was estimated in all childhood patients by MTT assay in vitro Result showed that LRP expression rate was 18 5% in 27 untreated childhood patients,66 7% in 21 relapsed refractory patients(P<0 01) In 27 cases untreated children,sensitivity rate to DNR in vitro was 86 4% in LRP expression negative,20% positive(P<0 01) In 21 cases relapsed refractory,sensitivity rate to DNR in vitro 28 6% in LRP expression negative ,21 4% positive (P>0 05) In 27 cases untreated children,CR rate was 90 9% in LRP expression negative,60% positive (P<0 01) In 21 cases relapsed refractory,CR rate was 42 9% in LRP expression negative,50% positive(P>0 05) So LRP expression may be another important factor in MDR of ALL and it can be considered as a index to judge clinical effect