急性白血病多药耐药相关蛋白及P糖蛋白表达与临床耐药的关系

目的 :研究急性白血病患者多药耐药相关蛋白 (MRP)及P 糖蛋白 (P 170 )的表达与临床耐药的关系。方法 :采用免疫组织化学方法检测 72例急性白血病患者骨髓单个核细胞MRP和P 170的表达。结果 :72例化疗后急性白血病患者中 ,MRP阳性表达 39例 ,阴性表达 33例 ,MRP阳性表达者疗效显著差于阴性表达者 (P <0 .0 1) ;P 170阳性表达 4 6例 ,阴性表达 2 6例 ,P 170阳性表达者疗效显著差于阴性表达者 (P <0 .0 1) ;MRP与P 170表达有一定的一致性 (Kappa系数 =0 .4 2 7,P<0 .0 1) ,两者同时检测对耐药患者的灵敏度为 97 5 % ,高于P 170检测的灵敏度 (90 % )和MRP检测的灵敏度 (77 5 % )。结论 :P 170和MRP表达与临床化疗耐药密切相关 ,P 170和 或MRP阳性表达者临床疗效显著差于阴性表达者。MRP与P 170两者同时检测可提高对耐药白血病患者的判断及预后估计

Expression of multidrug resistance P-170 and MRP and their correlation with clinical drug resistance in acute leukemia

Objective To investigate the relevance between the expression of P 170 and MRP and clinical drug resistance in acute leukemia. Methods The expression of P 170 and MRP in mononuclear cells of bone marrows was analyzed by the immunohistochemical technique in 72 acute leukemia patients. Results The expression of P 170 was positive in 46 and negative in 26 of the 72 post chemotherapy acute leukemia patients. The therapeutic effect of the P 170 positive expression patients was significantly poorer than that of the negative expression patients (P<0.01). The expression of MRP was positive in 39 and negative in 33 of the 72 post chemotherapy acute leukemia patients. The therapeutic effect of the MRP positive expression patients was significantly poorer than that in the negative expression patients (P<0.01). The expression of P 170 and MRP had a significant concordance (Kappa=0.427, P<0.01). The sensitivity of P 170 and MRP which were analyzed simultaneously was 97.5%, which was higher than that of P 170 (90%) or MRP (77.5%) analyzed respectively in drug resistance patients. Conclusion The expression of P 170 and/or MRP was significantly related with drug resistance in clinical chemotherapy. The therapeutic effect was significantly poorer in P 170 and/or MRP positive expression patients than that in negative expression patients. These data suggest that P 170 and MRP analyzed simulateously can improve the value of diagnosis and prognosis in patients with drug resistance leukemia.