摘要 目的：探讨急性髓系白血病(AML)的原发性耐药蛋白p170、GSTP-1等的表达和疗效、预后的关系。方法：采集AML患者治疗前骨髓液，采用ABC-AP法检测p170、GSTP-1和其他单抗。结果：①105例初治AML中12例（11.4%）出现p170或GSTP-1的阳性表达。②耐药表达阳性的12例中CR 6例（50%），有效率为66.7%；12例中目前7例死亡，2例复发，总生存曲线下降较快。无病生存曲线反映18个月追踪仅剩25%左右。结论：成人AML原发性耐药的表达是治疗效果差的标志之一，与预后直接相关。The expression of the primary multidrug resistance of
acute myeloid leukemia
ZENG Xiao-ying CHEN Jia-he SHEN Zhi-xiang ZHAO Hui-jin SHEN Yang LI Jun-min
(Department of Hematology, Ruijin Hospital, Shanghai Institute of Hematology, Shanghai Second Medical University, Shanghai 200025)
NI Ling HU Yi-qun
(Department of Clinical Assaying,Shanghai Second Medical University)
Abstract Objective:To analyse the relationship among the expression of multidrug resistance protein p170, GSTP-1 and the effectiveness of treatment and prognosis.Method:The bone marrow smears from newly diagnosed acute myeloid leukemia were studied by modified ABC-AP enzyme immunoassay method to evaluate the p170, GSTP-1 and the others.Result:①Twelve patients of 105(11.4%) had positive-expression of p170 or GSTP-1.②The CR rate was 50.0%, the effective rate (CR+PR) was 66.7% in positive-expression patients; The CR rate was 66.7%,the effective rate(CR+PR) was 82.8% in negative-expression patients.At present, seven patients died and two patients was relapsed from 12 positive-expression patients.The curve of Kaplan-Meier survival declined faster.Conclusion:Expression of MDR in adult patients with newly diagnosed acute myeloid leukemia was one of worse factors for effectiveness of treatment, and directly related to prognosis.
Key words Acute myeloid leukemia p170
急性白血病的原发性耐药的产生，近年来在国外屡有报道〔1〕，但国内大组病例的系列检测和预后关系的追踪报道尚不多见。我院自1998年8月～2000年2月收治初治急性髓系白血病(acute myeloid leukemia,AML)105例，对之进行p170、GST-1、CD33、CD34等蛋白检测，旨在探讨其阳性表达率与疗效、预后的关系。报告如下。
1 资料和方法
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