儿童急性白血病初治患者LRP和MRP的表达及其临床意义

背景与目的:有研究发现肺耐药相关蛋白(lungresistanceprotein,LRP)和多药耐药相关蛋白(multidrugresistance鄄associatedporotein,MRP)的表达与白血病患儿耐药有关,而且患儿耐药不是由于一种耐药机制引起的。本研究旨在观察LRP和MRP在不同类型小儿白血病初治时的表达情况及其与临床疗效的关系。方法:应用逆转录鄄聚合酶链反应法(RT鄄PCR)检测38例不同类型儿童急性白血病[27例急性淋巴细胞白血病(acutelymphoblastic,ALL),11例急性非淋巴细胞白血病(acutenonlymphocyticleukemia,ANLL)]及6名正常儿童LRP、MRP基因的表达,结合患儿化疗后的完全缓解(CR)率分析两种基因表达的意义。结果:38例患儿化疗后CR26例(68.4%)。38例患儿中LRP基因表达阳性11例(28.9%),表达阴性27例(71.1%),6例正常对照儿童LRP基因阴性。LRP基因阳性患儿的CR率低于阴性者(分别为27.3%和85.2%,P<0.05)。MRP阳性者21例,6例正常对照儿童MRP基因阴性。MRP基因阳性者的CR率低于阴性者(分别为47.6%和94.1%,P<0.05)。27例ALL患儿中LRP阳性5例,11例ANLL患儿中LRP阳性6例(分别为18.5%和54.5%,P<0.05)。27例ALL患儿中MRP阳性16例;11例ANLL患儿MRP阳性5例(分别为59.3%和45.5%,P>0.05),ALL和ANLL中MRP的表达无显著性差异。LRP基因阳性患者的MRP阳性率与LRP阴性者MRP阳性率无显著性差异(分别为28.6%和29.4%,P>0.05),说明LRP基因与MRP基因之间无相关性。结论:LRP基因及MRP基因阳性儿童急性白血病者病情重、化疗缓解率低,儿童ANLL相对于ALL化疗缓解率低可能与LRP的表达有关。

Expression of lung resistance protein and multidrug resistance-associated protein in naive childhood acute leukemia and their clinical significance

BACKGROUND & OBJECTIVE: Previous studies revealed that lung resistan ce protein (LRP) and multidrug resistance-associated protein (MRP) relate to dru g resistance of childhood leukemia, which is not caused by only one mechanism. T his study was to evaluate the expression of LRP and MRP genes in childhood leuke mia and their correlation. METHODS: The expression of LRP and MRP in 38 children with acute leukemia and 6 healthy children were measured with reverse transcrip tion-polymerase chain reaction (RT-PCR); their clinical significance was analyze d according to complete remission (CR) rate of the patients after chemotherapy. RESULTS: CR rate of the 38 patients was 68.4%. LRP was expressed in 11 of the 38 patients, and didn't express in healthy controls; CR rate was significantly l ower in LRP-positive patients than in LRP-negative patients (27.3% vs. 85.2%, P < 0.05). MRP was overexpressed in 21 of the 38 patients; CR rate was significant ly lower in MRP-positive patients than in MRP-negative patients (47.6% vs. 94.1% , P < 0.05). The positive rate of LRP was significantly lower in acute lymphobla stic leukemia (ALL) than in acute nonlymphocytic leukemia (ANLL) [18.5% (5/27) v s. 45.5% (6/11), P < 0.05]; however, the positive rate of MRP was 59.3% (16/27) in ALL, and 45.5% (5/11) in ANLL (P > 0.05). The positive rate of MRP was 28.6% in LRP-positive patients, and 29.4% in LRP-negative patients; there was no corre lation between LRP and MRP. CONCLUSION: Childhood acute leukemia patients with o verexpression of LRP and MRP suffer severe disease and achieve low remission rat e; lower remission rate of childhood ANLL patients may relate to LRP expression.