急性髓细胞白血病患者CD56抗原表达与MDR1基因表达量的关系研究

目的 研究初治急性髓细胞白血病(AML)患者CD56抗原表达与多药耐药(MDR)1基因表达量的关系,探讨CD56抗原表达与MDR1基因表达量在AML耐药中的作用及相互关系.方法 采用流式细胞术(FCM)和建立实时荧光定量PCR技术分别检测79例AML患者CD56抗原表达及MDR1基因表达水平并分析两者之间的关系及临床意义.结果 24.1%AML患者表达CD56抗原,FAB亚型中M5 AML患者表达阳性率高于其他亚型.遗传学危险度分级高危组患者CD56抗原表达阳性率显著高于中危组(P<0.01),伴t(8:21)AML患者CD56抗原表达阳性率(57.1%)显著高于其他低危组AML(P<0.05).CD56抗原表达阳性初治AML患者MDR1基因表达水平显著高于表达阴性患者(P<0.001).MDR1基因高表达且CD56抗原阳性AML组的CR率(58.8%)显著低于MDR1基因低表达且CD56表达阴性组(89.2%,P<0.01).结论 AML患者CD56抗原表达与MDR1基因表达水平存在相关性;同时定量检测MDR1基因表达及CD56抗原表达更有助于判断预后.

Significance of quantification of MDR1 gene and CD56 antigen expression in acute myeloid leukemia patients

Objective To study the relationship between the MDR1 gene expressions and CD56 antigen expression in patients with de novo acute myeloid leukemia(AML) and to explore the role of this two factors in clinical drug resistance and their correlation. Methods A real-time quantitative RT-PCR method was established for detecting MDR1 expression levels and three-color flow cytometry analysis using CD34/ SSC gating was used to examined CD56 antigen expression in 79 de novo AML patients. Results CD56 an-tigen was recorded in 19 out of 79 cases (24.1%) and particularly in those with M5 cytotypes. Moreover, CD56 expression was significantly associated with unfavorable cytogenetic abnormalities (P<0.05), Patients with t(8:21)had a significantly higher incidence (57.1%, 4/7) of CD56 expression than those with favora-ble karyotype(P<0.05). CD56~+ AML patients had a higher incidence of splenohepatomegalia and lactate dehydrogenase level than CD56~- patients(P<0.05). The median expression levels of MDR1 was statistical-ly higher in CD56~+ AML patients than that in CD56 patients(P<0.001). Patients with both high levels of MDR1 and CD56~+ had a significantly lower CR(complete remission) rate than those with both low MDR1 level and CD56 (58.8% vs 89.2%, P<0.01). Conclusion There is a linear correlation between MDR1 gene expression and CD56 expression in AML. Quantification of the MDR1 gene expression together with CD56 antigen expression is more effective to the judgement of prognosis in AML.