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目的：将简便可靠的非同位素原位杂交方法应用于急性白血病多药耐药基因（Ｍｄｒ１）的临床检测。方法：自行构建ＲＮＡ探针，经地高辛标记，直接在骨髓涂片上进行原位杂交，检测４５ 例急性白血病骨髓细胞Ｍｄｒ１ ｍ ＲＮＡ。对部分Ｍｄｒ１ 高表达者调整临床治疗。结果：杂交信号清晰，重现性好。复治组中Ｍｄｒ１ 阳性８８．２％ ，初治组４２．８％ ，差异有极显著性。经标准化疗２ 疗程后初治组中Ｍｄｒ１ 阳性组完全缓解（ＣＲ）率２２．２％ ，阴性组６３．６％ （ Ｐ＜ ０．００１）。对Ｍｄｒ１ 阳性病例调整化疗方案或加用逆转剂可改善预后。结论：Ｍｄｒ１ 高表达确为白血病不良预后的主要指标。本方法操作简便，结果可靠，可用于急性白血病Ｍｄｒ１ 常规检测，辅助临床治疗并及断预后。
OBJECTIVE: To apply the simple and reliable non-isotopic in situ hybridization method to the clinical detection of multidrug resistance gene (Mdr1) in acute leukemia. METHODS: RNA probes were self-constructed and labeled with digoxigenin. In situ hybridization was performed directly on bone marrow smears to detect Mdr1 m RNA in 45 acute leukemia bone marrow cells. Clinical treatment was adjusted for some of the Mdr1 hyperexpressors. Results: The hybridization signal was clear and reproducible. In the retreatment group, the positive rate of Mdr1 was 88.2%, and that of the untreated group was 42.8%. The difference was extremely significant. The rate of complete remission (CR) in the Mdr1 positive group was 22.2% in the untreated group and 63.6% in the negative group (P<0.001) after the standard chemotherapy 2 course of treatment. Adjusting chemotherapy regimens or adding reversal agents to Mdr1-positive patients can improve prognosis. Conclusion: High expression of Mdr1 is indeed the main indicator of poor prognosis of leukemia. The method is simple and reliable, and can be used for the routine detection of Mdr1 in acute leukemia, and assists clinical treatment and breaks the prognosis.