急性白血病患者谷胱甘肽S-转移酶和肺耐药相关蛋白的检测及临床意义

目的：探讨急性白血病(AL)患者细胞内谷胱甘肽S-转移酶活力(GST)及肺耐药相关蛋白(LRP)表达与临床疗效的关系。方法：采用化学比色法检测57例AL患者骨髓单个核细胞内GST活力并同时采用免疫细胞化学(SABC)方法检测LRP表达。结果：AL患者细胞内GST活力明显高于对照组(P<0.01)； AL患者细胞内GST活力与骨髓中原始及幼稚细胞百分数有一定相关性(r＝0.30, P<0.05)。初治组AL患者细胞内GST活力明显高于化疗后缓解(CR)组(P<0.01),化疗后难治复发组患者细胞内GST活力又明显上升，显著高于缓解组(P<0.01)。化疗后17例AL患者LRP表达阳性，其中13例未缓解(NR), 20例LRP表达阴性,其中CR12例，LRP阳性组疗效显著差于阴性组（P<0.05），且LRP阳性组NR患者及LRP阴性组NR患者GST活力均明显增高。结论：AL患者细胞内GST活力增高与临床疗效及骨髓原始及幼稚细胞增殖有关；同时检测AL患者GST活力与LRP表达对提高耐药白血病的疗效和预后有一定价值。

Detection of glutathione S-transferase and lung resistance-related proteins in acute leukemia and its clinical significance

Objective To explore the relationship among intracellular glutathione S-transferase activity(GST), the expression of lung resistance-related proteins(LRP) in acute leukemia, and its clinical effects. Methods The GST activity of bone marrow mononuclear cells and LRP expression in 57 acute leukemia patients were detected by the spectrophotometry assay and immuno-cytochemistry(SABC), respectively. Results The GST activity of bone marrow mononuclear cells in the acute leukemia group was significantly higher than that of the control group (P<0.01). The GST activity of mononuclear cells in acute leukemia was positively correlated with the percentage of blast in the bone marrow (r=0.30, P<0.05). The GST activity of mononuclear cells in the untreated acute leukemia group was obviously higher than that of the complete remission group (P<0.01). The GST activity in the refractory or relapsed acute leukemia group was significantly higher than that of the complete remission group and untreated leukemia group (P<0.05). In post-chemotherapy 13 of 17 the LRP-positive patients were the non-remission,12 of the 20 LRP-negative patients were the complete remission. The curative rate of the LRP-positive group was the significantly lower than the LRP-negative group (P<0.05). The GST activities of non-remission patients in the LRP-positive and LRP-negative group obviously increased. Conclusion The increase of GST activity in the bone marrow mononuclear cells is related to the clinical curative effects and the proliferation of blast in acute leukemia. Detection of LRP and GST activities in acute leukemia may have a reference value in judging the leukemia with drug resistance and estimating the prognosis.