论文部分内容阅读
目的 研究肺耐药相关蛋白 (LRP)、P糖蛋白 (Pg - p)和多药耐药相关蛋白 (MRP)表达与急性髓性白血病 (AML)患者多药耐药 (MDR)的关系及其临床意义。方法 将 12 9例AML患者分为初治组和复发难治组 ,用免疫组化法检测患者骨髓或外周血单个核细胞中LRP、Pg -p和MRP表达。根据上述三种蛋白的表达情况将LRP或Pg - p或MRP单一表达阳性者定为 :“单纯型” ;将LRP或Pg - p或MRP两项以上阳性者定为 :“混合型” ,观察这种分型与临床疗效的关系。同时用MTT技术观察了白血病细胞对柔红霉素 (DNR)的敏感性。结果 在AML初治组中耐药蛋白表达阴性者的完全缓解 (CR)率 75 .6 % ,而耐药蛋白表达阳性者CR率 2 0 .8% (“单纯型”2 1.1% ,“混合型”2 0 % ) ;在AML复发及难治组中 ,耐药蛋白表达为“混合型”者CR率 15 .4 % ,耐药蛋白表达为“单纯型”者CR率 2 9.6 % ,“混合型”CR率低于“单纯型”。结论 LRP、Pg -p和MRP均与耐药有关 ,这种“混合型”和“单纯型”耐药分类法 ,可以作为指导临床治疗和判断疗效的分类法
Objective To investigate the relationship between multidrug resistance (MDR) in patients with acute myelogenous leukemia (AML) and the expression of P - glycoprotein (Pg - p) and multidrug resistance - associated protein (MRP) Clinical significance. Methods One hundred and ninety-nine patients with AML were divided into primary treatment group and refractory relapsed group. The expression of LRP, Pg-p and MRP in bone marrow or peripheral blood mononuclear cells were detected by immunohistochemistry. According to the above three protein expression of LRP or Pg - p or MRP single expression positive as: “simple type”; LRP or Pg - p or MRP more than two positive as: “mixed type” observed The relationship between this classification and clinical efficacy. The sensitivity of leukemia cells to daunorubicin (DNR) was also observed by MTT assay. Results The complete remission (CR) rate was 75.6% in those with negative expression of resistance protein in the primary AML group, while the CR rate was 0.08% in those with positive expression of resistance protein (1.1% in the “simplex” Type “20%). In AML relapse and refractory group, the CR rate was 15.4% in the mixed type and 2 9.6% in the simple type, Mixed ”CR rate lower than“ simple type. ” Conclusions LRP, Pg-p and MRP are all related to drug resistance. The “mixed” and “simplex” drug resistance classification methods can be used as a classification to guide the clinical treatment and to judge the curative effect