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目的 探讨急性白血病 (急白 )患者多药耐药基因 ( MDR1 )表达的临床意义和应用。方法 对 3 5例初治急白患者采用 S- P免疫组化染色法检测 MDR1 表达产物 ( Pgp) ,对部分患者进行动态观察并配合药敏测定 ,了解急白患者化疗前后耐药情况的变化。结果 本组 3 5例 MDR1 表达阳性者 14例 ( 4 0 % ) ,其中急性淋巴细胞白血病 (急淋 ) 9例 ,急性非淋巴细胞白血病 (急非淋 ) 5例 ,两者无显著差异 ( P>0 .0 5 )。 14例 MDR1 表达阳性者 ,达完全缓解( CR) 7例 ( 5 0 % ) ;2 1例 MDR1 表达阴性者 ,达 CR19例 ( 90 % ) ,有显著差异 ( P<0 .0 5 )。对 10例行柔红霉素( DNR)药敏测定 ,5例 MDR1 阴性者对 DNR高敏 ,5例 MDR1 阳性者 ,1例对 DNR高敏 ,4例低敏。结论 急白患者 MDR1 阳性 ,则化疗效果差 ,预后不良 ,对指导临床化疗方案设计 ,预测化疗疗效有重要意义。
Objective To investigate the clinical significance and application of multidrug resistance gene (MDR1) expression in acute leukemia patients. Methods The expression of MDR1 expression product (Pgp) was detected by SP immunohistochemical staining in 35 patients with initial acute white matter. Dynamic observation and drug susceptibility testing were performed on some patients to understand the changes of drug resistance before and after chemotherapy in acute white patients. . Results In this group, 35 cases of MDR1 expression were positive in 14 cases (40%), including 9 cases of acute lymphoblastic leukemia (acute lymphocyst) and 5 cases of acute nonlymphocytic leukemia (emergency non-lymphocyst). There was no significant difference between the two groups (P >0 .0 5 ). Among the 14 patients with positive MDR1 expression, 7 (50%) achieved complete remission (CR); 21 patients with negative MDR1 expression reached CR19 (90%), with significant differences (P<0.05). Of the 10 patients who underwent DNR susceptibility testing, 5 patients with MDR1 negative were hypersensitivity to DNR, 5 patients were MDR1 positive, 1 patient was hypersensitive to DNR, and 4 patients were hyposensitized. Conclusions MDR1 positive patients in acute white patients have poor chemotherapeutic effect and poor prognosis. It is of great significance to guide clinical chemotherapy design and predict chemotherapy efficacy.