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目的 探讨急性白血病 (AL)患者肺耐药蛋白 (LRP)基因表达与临床耐药的关系。方法 应用半定量逆转录 聚合酶链反应 (RT PCR) ,并以 β2 微球蛋白 (β2 MG)作内对照 ,检测了 6 1例AL患者及 15名正常对照者LRP基因的表达 ,将LRP/ β2 MG≥ 0 .3定为LRP阳性。结果 初治组LRP的阳性率为 32 .4% ,LRP阳性与LRP阴性患者的首次完全缓解 (CR1)率分别为 33.3%和 84.0 % ,两者的差异有显著性 (P <0 .0 0 5 ) ;复发难治组LRP基因表达水平及阳性率均显著高于初治组 (P <0 .0 1) ;正常对照组及长期生存组LRP基因表达水平较低 ;LRP基因表达与FAB分型有关。同时检测了 6 1例AL患者多药耐药基因mdr 1的表达 ,发现两种基因同时表达的AL患者预后极差 ;LRP和mdr 1表达之间无相关性 (P >0 .5 )。结论 LRP基因过度表达可导致临床耐药 ,是AL患者预后的重要不利因素。
Objective To investigate the relationship between lung resistance protein (LRP) gene expression and clinical drug resistance in patients with acute leukemia (AL). Methods Reverse transcription-polymerase chain reaction (RT-PCR) and β2 microglobulin (β2 MG) as internal control were used to detect the expression of LRP gene in 61 AL patients and 15 healthy controls. The LRP / β2 MG ≥ 0 .3 LRP positive. Results The positive rate of LRP in primary treatment group was 32.4%, and the first complete remission (CR1) rates in LRP positive and LRP negative patients were 33.3% and 84.0%, respectively, with significant difference (P <0. 0 0 5). The expression of LRP gene in the refractory and relapsed cases was significantly higher than that in the untreated group (P <0.01). The expression of LRP gene in the normal control group and the long-term survival group was lower than that in the untreated group Type related. At the same time, the expression of multidrug resistance gene mdr 1 was detected in 61 AL patients. It was found that AL patients with both genes expressed poor prognosis. There was no correlation between LRP and mdr 1 expression (P> 0.05). Conclusion LRP gene overexpression leads to clinical drug resistance, which is an important adverse prognostic factor in AL patients.