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目的 :应用逆转录 -聚合酶链反应 (RT- PCR)方法检测多药耐药基因 (mdr1 ) m RNA的表达 ,以探讨白血病细胞的抗药性与化疗效果的关系。方法 :采用 RT- PCR法检测 33例不同类型白血病患者 mdr1 m RNA的表达 ,同时检测 2 0例正常骨髓做对照。结果 :对照均为阴性表达 ,而初治组 mdr1 的阳性表达率为 35 .0 0 % ,复发、难治组 m dr1 阳性表达率为 84.6 2 % (P <0 .0 1) ,mdr1 阳性与 m dr1 阴性患者的完全缓解率分别为 2 2 .2 2 %和73.33% (P <0 .0 1) ,临床耐药与非耐药组 mdr1 阳性检测率分别为 77.78%和 2 6 .6 7% (P <0 .0 1)。结论 :临床白血病化疗耐药的发生主要与 mdr1 阳性表达有关。 RT- PCR是一种敏感性高、特异性强 ,可定量检测 mdr1 表达的手段。 mdr1 表达可作为一个临床化疗耐药指标 ,有助于白血病个体化疗方案制定。
Objective: To detect the expression of multidrug resistance gene (mdr1) m RNA by reverse transcriptase-polymerase chain reaction (RT-PCR) to explore the relationship between the drug resistance of leukemic cells and the effect of chemotherapy. Methods: The expression of mdr1 m RNA in 33 cases of different types of leukemia was detected by RT-PCR. 20 cases of normal bone marrow were detected as control. Results: The expression of mdr1 was 35.0% in the newly diagnosed group, the positive rate of m dr1 was 84.6% (P <0.01) in the relapsed and refractory group, the positive rate of mdr1 was The complete remission rates of m dr1-negative patients were respectively 22.22% and 73.33% (P <0.01), and the positive rates of mdr1 were 77.78% and 26.76 % (P <0 .0 1). Conclusion: Chemoresistance in clinical leukemia is mainly associated with the expression of mdr1. RT-PCR is a sensitive, specific, quantitative detection of mdr1 means. mdr1 expression can be used as a clinical chemoresistance index, contribute to the development of individual chemotherapy regimen of leukemia.