急性白血病细胞P-gp LRP的表达及其临床意义

目的：研究急性白血痛细胞P-糖蛋白（P—gp）、肺耐药蛋白（LRP）的表达情况，观察其表达率与临床症状及化疗缓解率的关系。方法：利用P—gp、LRP单克隆抗体，采用流式细胞技术分别测定15例正常对照和79例急性白血病（AL）患者P-gp、LRP的表达率，分析两种蛋白表达的临床意义。结果：初治急性淋巴细胞白血病（ALL）组P—gp、LRP的表达率均高于初治急性髓细胞白血病（AML）组（P〈0．01），复发／难治ALL组P—gp的表达率与复发／难治AML组相比无显著性差异（P〉0．05），而LRP的表达率较复发／难治AML组的表达率高（P〈0．01）。复发／难治组P—gp、LRP的表达率均高于相应的初治组（P〈0．05）。急性白血病患者P—gp、LRP的表达之间无相关性（L=0．0746，P〉0．05）。急性白血病细胞P—gp^＋／LRP^＋组缓解率低于P—gp^＋／LRP^-、P—gp^-／LRP^＋组（P〈0．05），并明显低于P—gp^-／LRP^-组（P〈0．01）。结论：复发／难治组P—gp、LRP的表达率高于初治组，而两者的表达率无相关性。P—gp、LRP表达阳性的患者缓解率低，且易出现髓外浸润。同时检测P—gp、LRP的表达较单独检测一种蛋白更具有临床意义。

Expression and Clinical Significance of P-gp and LRP in Acute Leukemia

Objective:To investigate the expression of P-glycoprotein (P-gp) and lung resistance protein (LRP) in acute leukemia and to observe the relationship between these expression levels and the clinical remission rate. Methods:Flow cytometry (FCM) was used to detect the rate of P-gp and LRP expression in 15 normal controls and 79 patients with acute leukemia (AL) and the data were used to analyze the clinical significance of the two proteins. Results:The expression rates of P-gp and LRP in the initial acute lymphocytic leukemia (ALL) treatment group were significantly higher compared to the acute myeloid leukemia (AML) group (P<0.01). There was no difference in the rate of P-gp expression between the relapse/refractory ALL group and the AML group (P>0.05), but the rate of LRP expression in the relapse/refractory ALL group was significantly higher than that of the AML group (P<0.01). The rates of P-gp and LRP expression in the relapse/refractory AL group were significantly higher than those of the corresponding initial group (P<0.01). No correlation was found between P-gp and LRP expression in acute leukemia patients (rs=0.0746, P>0.05). The remission rate of the P-gp+/LRP+ group was lower than that of the P-gp+/LRPand the P-gp-/LRP+ groups, and it was significantly lower than that of the P-gp-/LRPgroup with AL (P<0.01). Conclusion:The expression rates of P-gp and LRP in relapse/refractory patients are higher than those of the initial treatment group. There is no correlation between P-gp and LRP expression in AL. The remission rates of P-gp and LRP positive patients are lower, with rapid extramedullary infiltration. There was more clinical significance if P-gp and LRP were detected simultaneously. Compared to simple detection of a protein, homochronous detection of P-gp and LRP protein expression is of more clinical significance.