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目的 :探讨 P-糖蛋白 (P- gp)在急性淋巴细胞白血病的表达 ,评估 P- gp与急性淋巴细胞白血病预后的关系。方法 :用流式细胞仪 ,采用直接免疫荧光法 ,检测 2 0例急性淋巴细胞白血病患者抗 P- gp单克隆抗体 U IC2及 CD3、CD5 、CD7、CD1 0 、CD1 9、CD1 3 、CD1 4 、CD33 、CD34的表达 ,被检患者外周血或骨髓中幼稚细胞数≥ 5 0 % ,并设非耐药细胞系 K5 6 2为阴性对照。结果 :2 0例 AL L患者中 8例 P- gp表达阳性 ,12例 P- gp表达阴性。 P- gp阳性表达率为 40 %。髓系抗原表达阳性者 P- gp阳性率为 33.3 % ,髓系抗原表达阴性者 P- gp阳性率为 45 .5 % ,P>0 .0 5。 2例急性 T淋巴细胞白血病 CD7表达阳性 ,且 P- gp表达皆阳性。 P- gp阳性组 8例患者中 5例治疗有效 ,P- gp阴性组 12例中 10例治疗有效 ,P- gp表达阳性者中 3例 6月内复发。结论 :急性淋巴细胞白血病 P- gp阳性表达率为 40 % ;P-gp表达与髓系抗原表达无相关性 ,与 CD7表达有关 ;P- gp表达阳性与急性淋巴细胞白血病化疗效果有相关性 ,P-gp表达阳性者易早期复发。
Objective: To investigate the expression of P-glycoprotein (P-gp) in acute lymphoblastic leukemia and to evaluate the relationship between P-gp and prognosis of acute lymphoblastic leukemia. METHODS: Using flow cytometry, direct immunofluorescence was used to detect anti-P-gp monoclonal antibody U IC2 and CD3, CD5, CD7, CD1 0, CD1 9, CD1 3, CD1 4 in 20 patients with acute lymphoblastic leukemia. The expression of CD33, CD34, and the number of immature cells in the peripheral blood or bone marrow of the examined patients were ≥ 50%, and the non-drug resistant cell line K562 was considered as a negative control. RESULTS: Of the 20 patients with AL L, 8 were positive for P-gp expression and 12 were negative for P-gp expression. The positive rate of P-gp was 40%. The positive rate of P-gp was 33.3% in patients with positive myeloid antigen expression and 45.5% in patients with negative myeloid antigen expression, P>0.05. Two cases of acute T-lymphocytic leukemia were positive for CD7 expression, and P-gp expression was positive. In the P-gp positive group, 5 of 8 patients were treated effectively, of the 12 patients in the P-gp negative group, 10 were effective, and 3 of the P-gp positive patients relapsed within 6 months. Conclusion: The positive expression rate of P-gp in acute lymphoblastic leukemia is 40%. There is no correlation between P-gp expression and myeloid antigen expression, which is related to the expression of CD7. The positive expression of P-gp is related to the chemotherapy effect of acute lymphoblastic leukemia. P-gp positive expression is easy to relapse early.