摘要
目的 探讨P糖蛋白 (P gp)、mdr1、MRP和TopoⅡ是否为急性白血病 (AL)临床耐药的预后因素。方法 用单抗UIC2标记 ,流式细胞术测定 45例AL患者的P gp ;用RT PCR方法检测其mdr1、MRP和TopoⅡ的表达。结果 耐药组P gp、mdr1、MRP阳性率均高于敏感组 ,P值均 <0 .0 1,而TopoⅡ耐药组表达阳性率较敏感组降低 ,但差异无统计学意义。经单因素逻辑回归分析 ,P gp、mdr1、MRP、TopoⅡ和年龄与临床耐药性显著相关 ;性别、发病时白细胞计数、FAB亚型和骨髓原始 + (早 )幼稚细胞比例与耐药性无关。采用多因素逻辑回归分析经以上变量校正后显示P gp、mdr1、MRP、TopoⅡ和年龄仍与耐药性显著相关 :P gpRR =14.87,P =0 .0 0 3;mdr1RR =19.98,P =0 .0 0 3;MRPRR =16 .5 3 ,P=0 .0 0 6 ;TopoⅡRR =0 .2 3,P =0 .0 46 ;年龄RR =10 .87,P =0 .0 13。将 36例初发AL患者单独分析 ,结果发现P gp、mdr1和MRP亦与完全缓解密切相关。经直线相关分析发现所有病例组和临床耐药组P gp和mdr1,P gp和MRP ,mdr1和MRP具有相关性 (P <0 .0 0 1)。结论 P gp、mdr1、MRP和TopoⅡ是AL临床耐药的独立预后因素。mdr1和MRP具有相关性。
Objective To investigate whether P gp, mdr1, MRP and Topo Ⅱ are the prognostic factors of clinical resistance in acute leukemia (AL) patients. Methods The expression of P gp was analyzed by flow cytometry using monoclonal antibody UIC2, the expressions of mdr1, MRP and Topo Ⅱ by RT PCR in 45 AL samples. Results The expressions of P gp, mdr1 and MRP were significantly higher in resistant group than that in sensitive group(P<0.01). The expression of Topo Ⅱ was lower in resistant group, but the difference was not statistically significant. Logistic regression of univariate analysis showed that the overexpression of P gp, mdr1 and MRP, the lower expression of Topo Ⅱ and age over 55 were the prognostic factors of clinical resistance in AL. Sex, initial white blood cell count (WBC), bone marrow (BM) blast percentage and FAB subtypes were not significant for the clinical resistance. Multivariate analysis adjusted by above factors showed that the overexpression of P gp, mdr1 and MRP, the low expression of Topo Ⅱ and age over 55 were still highly significant for clinical resistance. It was also found that there were significant correlations between P gp, mdr1, MRP and complete remission in 36 newly diagnosed AL. Significant correlations were observed between P gp and mdr1, mdr1 and MRP,and P gp and MRP expression in all AL cases and in clinical resistance group(P<0.001). Conclusions The overexpression of P gp, mdr1 and MRP, and the lower expression of Topo Ⅱ are the unfavorable prognostic factors of clinical resistance in AL. There is correlation between mdr1 and MRP expressions.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2001年第2期90-93,共4页
Chinese Journal of Hematology
