急性白血病多药耐药相关蛋白的检测及临床意义

目的探讨多药耐药相关蛋白 (MRP)的表达与临床耐药的关系。方法以免疫组化ABC法检测了 5 3例急性白血病 (AL)患者和 15例对照组骨髓单个核细胞MRP的表达情况 ,并同时检测了P -170的表达。结果① 40例化疗后患者 ,MRP阳性表达 2 3例 ,其中疗效差 18例 ,疗效佳 5例 ;MRP阴性表达 17例 ,其中疗效差 7例 ,疗效佳 10例。MRP阳性组疗效显著差于阴性组(P <0 .0 5 )。② 40例化疗后患者 ,P -170阳性组疗效显著差于阴性组 (P <0 .0 1)。③化疗后患者MRP与P -170表达具有一定的一致性(Kappa系数 =0 .36 7,P <0 .0 1) ,且两者与临床疗效有关。结论①MRP的过高表达是多药耐药 (MDR)产生机制中又一因素 ;②MRP与P -170表达有一定的一致性 ,且与临床疗效有一定关系 ;③MDR采用多项指标检测有助于AL疗效判断及预后预测。

Detection of Multidrug Resistance-related Proteins in Acute Leukemia and its Clinical Significance

Objective To investigate the relationsh ip between theexpression of multidrug resistance-related protein(MRP) and clini cal drug resistance. Methods The expression of MRP in mononuclear cells of bone marrows was detected in 53 acute leukemia patients and 15 normal controls b y immunohistochemical technique. At the same time, Pglycoprotein (P－170) expre ssion was also detected. Results① After treatment with chemotherapy,23 out of 40 patients had overexpression of MRP,18 among them showed poor therapeutic effect and 5 with remission; MRP expression was negative in 17 patients,7 of them showed poor effect and 10 with remission. The remission ratio in MRP negative patients was significantly higher than that in MRP positive patients(P<0.0 5).②Having treated with chemotherapy, the remission ratio in P－170 positive group among 40 patients was significantly lower than that in P－170 negative group (P<0.01).③After chemotherapy, the expression of MRP in patients was concord ant with that of P－170 to a certain extent(Kappa=0.367,P<0.01), and both expression were related with clinical curative effect. Conclusions①Overexpres sion of MRP is another factor in its mechanism of production;②The expression of MRP and P－170 is concordant, and both are related with clinical curative effect;③Examination of multiple criteria in multidrug resistance (MDR) helps to app raisal of therapeutic efficacy and prediction of prognosis.