急性髓系白血病生存素、多药耐药基因与肺耐药基因的表达及其临床意义

Clinical significance of survivin, multidrug resistance and lung resistance protein gene expression in acute myeloid leukemia

目的 :探讨初治急性髓系白血病 (AML)细胞生存素 (Survivin ,S)、多药耐药基因 (mdr 1)与肺耐药蛋白 (LRP)表达与疗效的关系。方法 :应用RT PCR法检测 4 6例初治AML患者的S、mdr 1和LRPmRNA表达的阳性率。结果 :4 6例AML患者细胞SmRNA阳性率为 6 9.6 % ,mdr 1mRNA阳性率为 5 2 .2 % ,均分别高于正常对照组 (2 7.8% ,11.1% ,P <0 .0 1) ,而表达LRP阳性率与正常对照组差异无显著性意义 ,分别为 36 .9%和16 .7% (P >0 .0 5 )。S阳性者CR(6 2 .5 % )明显低于阴性者 (92 .9% ,P <0 .0 5 )。mdr 1阳性者CR(45 .8% )明显低于阴性者 (10 0 % ,P <0 .0 1)。LRP阳性者CR(41.2 % )明显低于阴性者 (89.7% ,P <0 .0 1)。S和mdr 1双阳性者CR(45 .5 % )明显低于双阴性者 (10 0 % ,P <0 .0 1)。S和LRP双阳性者CR(35 .7% )明显低于双阴性者(10 0 % ,P <0 .0 1)。结论 :S、mdr 1和LRP可作为独立预后因素。S和mdr

Objective:To evaluate the effect of survivin (S),multidrug resistance (mdr 1) and lung resistance protein (LRP) gene expression on therapeutic efficacy in acute myeloid leukemia (AML). Method:By using reverse transcriptase polymerase chain reaction (RT PCR), S, mdr 1 and LRP gene expression were studied in 46 de novo AML cases.Result:In AML the positivily of S and mdr 1 expression was 69.6 % and 52.2 % respectively, significantly higher than that of control ( 27.8 % and 11.1 % respectively, P< 0.01 ). But there was no difference in the LRP expression between AML ( 36.9 %) and control ( 16.7 %, P> 0.05 ). The complete remission rate (CR) in S positive AML cases ( 62.5 %) was significantly lower than that in S negative cases ( 92.9 %, P< 0.05 ).Mdr 1 positive cases had a lower CR ( 45.8 %) in comparison with mdr 1 negative ones (100%, P< 0.01 ). In LRP positive cases the CR ( 41.2 %) was also lower than that in LRP negative cases ( 89.7 %,P< 0.01 ). patients with both positive for S and mdr 1 had a lower CR ( 45.5 %), as compared with double negative cases (100%, P< 0.01 ). Cases with positive for both S and LRP also showed a lower CR ( 35.7 %), in comparison with double negative ones (100%, P< 0.01 ). Conclusion:S, mdr 1 and LRP each could act as independent prognostic factor. The CR was significantly lower in cases with double positivity of S and mdr 1 or S and LRP.