急性白血病患者LRP、GST-π、MRP1蛋白表达及临床意义

本研究探讨谷胱甘肽硫转移酶-π(GST-π)、多药耐药相关蛋白1(MRP1)、肺耐药相关蛋白(LRP)与急性白血病(AL)多药耐药(multi-drug resistance,MDR)的关系、并探讨这3种耐药蛋白表达的相关性以及三者表达与AL患者临床特征的关系。采用免疫组织化学S-P法检测80例AL患者及30例正常人GST-π、MRP1及LRP的表达。结果表明:GST-π,MRP1,LRP蛋白表达均与临床耐药相关,3种耐药蛋白表达阳性组的完全缓解率均低于阴性组,提示耐药蛋白表达时白血病患者预后不良。GST-π、MRP1在AL难治组中的表达具有高度相关性。结论:GST-π/MRP1二者联合检测对评定白血病预后不良较单独测定某一蛋白更具有显著的临床意义。当外周血白细胞数≥10×109/L时,LRP阳性表达率显著增高,提示LPR对高白细胞数白血病患者的耐药性和预后评定具有很高的判断价值。

Expressions of LRP, GST-π and MRP1 in Acute Leukemia Patients and Its Clinical Significance

This study was purposed to investigate the relationship of expressions of gluthatione-S-transferase-pi (GST-pi), multidrug resistance protein-1 (MRP-1), lung resistance protein (LRP) with multidrug resistance of acute leukemia (AL), the correlation between 3 kinds protein expressions and the correlation of their protein expression with clinical features of AL patients. The S-P immunohistochemical staining method was used to determine the expressions of GST-pi, MRP1 and LRP proteins in 80 AL patients and 30 normal subjects. The results showed that there was the correlation between GST-pi, MRP1, LRP protein expression and chemotherapy resistance, meanwhile CR rates of patients with positive expression of those proteins were lower than that of patients with negative expression (P<0.05), so those protein expressions may be accounted for poor prognosis. There was the positive relationship between expression of GST-pi and MRP1 in refractory group (r=0.851, P<0.01). It is concluded that co-examination of GST-pi and MRP1 has greater significance than examination of one kind of protein in evaluating poor prognosis of leukemia patients. LRP protein expression increase obviously when WBC counts >or= 10 x 10(9)/L (63.6%, P<0.05), therefore LRP protein has great judging value for evaluating drug resistance and prognosis of acute leukemia patients whose peripheral blood WBC counts were high.