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目的 :研究多药耐药基因 mdr-1和凋亡抑制基因 bcl-2对白血病预后的影响。方法 :用免疫组织化学染色方法检测白血病患者 P-糖蛋白 ( Pgp)和 bcl-2蛋白的表达 ,分析其与化疗效果的关系。结果 :在 15 4例急性白血病患者中 ,Pgp和 bcl-2蛋白表达的阳性率分别为 47.4%和 72 .1% ,与 FAB分型无关。复发患者的 Pgp阳性率( 6 4.6 % )高于初治患者 ( 39.6 % ) ( P<0 .0 1) ,bcl-2阳性率在初治与复发患者之间无显著差异。Pgp和 bcl-2蛋白表达均阳性者完全缓解率 ( 2 5 % )低于 Pgp和 bcl-2蛋白表达均阴性者 ( 6 3.6 % ) ( P<0 .0 5 )。结论 :Pgp和 bcl-2蛋白联合检测对评价急性白血病的预后具较大的临床意义。
Objective: To study the effect of multidrug resistance gene mdr-1 and apoptosis inhibitor gene bcl-2 on the prognosis of leukemia. Methods: The expression of P-glycoprotein (Pgp) and bcl-2 protein in leukemia patients was detected by immunohistochemical staining. The relationship between the expression of Pgp and bcl-2 protein was analyzed. Results : The positive rates of Pgp and bcl-2 protein expression in 454 patients with acute leukemia were 47.4% and 72.1%, respectively, which was not related to the FAB classification. The positive rate of Pgp in patients with relapse (64.6%) was higher than that in untreated patients (39.6 %) (P < 0.01). There was no significant difference in the positive rate of bcl-2 between primary and relapsed patients. The complete response rate of Pgp and bcl-2 protein positive expression (25 %) was lower than that of Pgp and bcl-2 protein expression negative (6 3.6 %) (P < 0.05). Conclusion: The combined detection of Pgp and bcl-2 protein has great clinical significance in evaluating the prognosis of acute leukemia.