多药耐药P糖蛋白检测与急性白血病预后相关性研究

Detection of multidrug resistance associated P glycoprotein and its correlation with prognosis in patients with acute leukaemia

  • 摘要: 目的: 探讨多药耐药(MDR)P糖蛋白(P170)表达与急性白血病预后关系。方法: 采用抗P170单克隆抗体JSB-1及碱性磷酸酶抗碱性磷酸酶免疫细胞化学技术检测86例(104例次)急性白血病骨髓细胞P170表达。结果: P170阳性率难治组为76.9%(10/13),复发组40.9%(9/22),初治组27%(10/37),完全缓解组18.8%(6/32)。初治组P170阴性病例首次诱导完全缓解(CR1)率81.5%,P170阳性CR1率40%(P<0.05)。复发组P170阴性患者再诱导化疗完全缓解(CR2)率30.8%(4/13),P170阳性患者CR2率11.1%(1/9)。结论: P170表达与急性白血病缓解、复发及耐药有关。P170检测有助于判断急性白血病疗效及预后,并为临床选择应用逆转剂治疗耐药病例提供依据

     

    Abstract: Objective: To evaluate the clinical value of the expression of multidrug resistance (MDR) P-glycoprotein (P170 in patients with acute leukaemia. Methods: 104 specimens were analyzed from 86 patients with acute leukaemia by using monoclonal JSB 1 with immunocytochemical staining technique of alkline phosphatase anti alkaline phosphatase(APAAP). Results: That P170-positive cases were 76.9% (10/13) in refractory group, 40.9% (9/22) in relapse group, 27% (10/37) in fresh case group and 18.8% (6/32) in complete remission group, respectvely. The lst induction remission rate (CR) was 81.5%(22/27) in P170-negative cases and 40% (4/10) in P170-positive cases in fresh case group (P <0.05). The second remission rate (CR2) was 30.8%(4/13) and 11.9%(1/9) in P170-negative and P170-positive in relapsed patients respectively. the relapse rate was also different in patients with CR of 25% (11/44) in P170-negative and 70% (7/10) in P170-positive cases (P <0.05). Conclusion: It is suggested that P170 expression is significantly associated with the clinical resistance to chemotherapy. The detection of P170 may be a useful method of predicting theraputic response and designing treatment protocols drug resistant in leukaemia patients.

     

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