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目的 :研究急性白血病 (AL)细胞内端粒酶活性与 AL 预后、分型及多药耐药 (m dr- 1)基因表达的相关性。方法 :用 TRAP法和 RT- PCR法分别测定 44例 AL 细胞内端粒酶活性和 mdr- 1基因的表达。结果 :44例 AL患者的白血病细胞端粒酶阳性率为 43.2 % ,mdr- 1阳性率为 40 .9% ;端粒酶阳性者 CR率为 5 7.6 % ,阴性者 CR率为 88.0 % (P <0 .0 1) ;端粒酶表达与 mdr- 1未显示出一致性 ,但端粒酶与 m dr- 1均阳性者 CR率为 33.3% ,均阴性者 CR率则高达 86 .7% (P <0 .0 1) ;端粒酶在复发难治者的表达明显高于非复发难治者 (P <0 .0 1) ;端粒酶在急性淋巴细胞白血病中的表达显著高于急性非淋巴细胞白血病 (P<0 .0 1)。结论 :端粒酶活性阳性的 AL 患者预后较差 ;端粒酶活性与 mdr- 1的表达无关 ,提示端粒酶阳性可能是一种影响 AL 预后的机制之一。
Objective: To study the correlation between telomerase activity and the prognosis, classification and multidrug resistance (MDR-1) gene expression in acute leukemia (AL) cells. Methods: The telomerase activity and mdr-1 gene expression in 44 AL cells were detected by TRAP and RT-PCR respectively. Results: The telomerase positive rate of leukemia cells was 43.2% in 44 AL patients, the positive rate of mdr-1 was 40.9%, the telomerase positive rate of CR was 57.6%, and the negative rate of CR was 88.0% (P <0.01). The telomerase expression was not consistent with mdr-1, but the CR rate of both telomerase and m dr-1 positive was 33.3%, and the CR rate of all patients with negative expression was as high as 86.7% (P <0.01). The expression of telomerase in patients with relapsed or refractory was significantly higher than those without recurrence (P <0.01). The expression of telomerase in acute lymphoblastic leukemia was significantly higher than Acute non-lymphocytic leukemia (P <0.01). CONCLUSION: The prognosis of AL patients with telomerase activity is poor. The telomerase activity has nothing to do with the expression of mdr-1, suggesting that telomerase positive may be one of the mechanisms that affect the prognosis of AL.