急性白血病mdr-1、bcl-2的表达及其临床意义

目的探讨mdr-1基因与bcl-2基因表达对急性白血病患者疗效判断的临床意义。方法应用逆转录-聚合酶链反应(RT-PCR)法检测51例急性白血病患者mdr-1基因及bcl-2基因的表达,结合临床分析,观察mdr-1基因及bcl-2基因的表达与临床化疗疗效的关系。结果51例急性白血病患者中mdr-1基因表达阳性21例(41.2%),bcl-2基因表达阳性28例(54.9%)。相关分析表明,mdr-1阳性表达与bcl-2阳性表达无相关关系(Pearsonγ=0.15,P>0.05)。mdr-1基因表达阴性者治疗完全缓解(CR)率达70.0%,明显高于表达阳性者CR率(19.0%)(P<0.05);bcl-2基因表达阴性者CR率为78.3%,明显高于表达阳性者的25%(P<0.05)。两者表达均为阳性者14例中CR1例,CR率为7.1%,表达均为阴性者16例中CR15例,CR率为93.8%,两者比较有极显著差异(P<0.01)。结论检测mdr-1基因或bcl-2基因对判断急性白血病的疗效有良好的预测作用,联合检测意义更大,可作为临床判断疗效的一项有意义的指标。

The clinical significance of mdr - 1 gene and bcl - 2 gene in acute leukemia

Objective To evaluate the relationship between the expression of mdr-1 or bcl-2 and the clinical significance in acute leukemia. Methods Expressions of mdr-1 and bcl-2 genes were measured in 51 acute leukemia patients by semi-quantitative RT-PCR method.Results Expression of mdr-1 gene was found in 21 of 51 (41.2%)and bcl-2 gene was found in 28 of 51(54.9%) acute leukemia patients. Relationship analysis showed that expression of mdr-1 gene was not significantly related to bcl-2 expression, the relative coefficient was 0.15, P>0.05. The complete remission rate in mdr-1 negative patients was 70.0%, which was much higher than those mdr-1 was positive expression whose CR rate was 19.0% (P<0.05). Complete remission rate in bcl-2 negative patients was 78.3%, while it was 25% in bcl-2 positive patients, which showed significant difference (P<0.05). Clinical observation showed that in 14 both positive expression of mdr-1 and bcl-2, only 1 got CR(7.1%);while 15 of 16 patients of both negative expression got CR(93.8%). Conclusion The patients who showed negative expression of both mdr-1 and bcl-2 had higher complete remission rate than either or both positive one. These results indicate that co-observation of the expression of mdr-1 gene and bcl-2 gene can predict the curative effect in acute leukemia.