CAJ | 학술논문

目的：分析多药耐药相关蛋白(MRP1)mRNA在急性淋巴细胞性白血病(ALL)患儿中的表达及其临床意义。方法入选67例初诊ALL患儿及10例正常对照儿童，采集骨髓。应用定量RT-PCR方法检测并比较骨髓中MRP1 mRNA表达水平。结果标危、中危、高危组MRP1 mRNA表达水平分别为4.28(2.75~6.12)、5.62(4.99~8.60)和7.56(3.66~11.13)，三组间差异有统计学意义(P<0.01)；高危组和中危组的MRP1 mRNA均高于与标危组，差异有统计学意义(P<0.05)。T-ALL组MRP1 mRNA表达水平为7.71(6.49~14.35)，高于B-ALL组的表达水平[5.18(3.89~8.46)]，差异有统计学意义(P<0.01)。高表达组(n=34)第7天泼尼松预处理敏感率为70.59%，而低表达组(n=33)敏感率为90.91%，差异有统计学意义(P<0.05)。高表达组第33天骨髓完全缓解率为64.71%，低表达组为87.88%，差异也有统计学意义(P<0.05)。结论ALL患儿MRP1表达与免疫分型、治疗反应以及疾病危险程度和复发紧密相关。
목적：분석다약내약상관단백(MRP1)mRNA재급성림파세포성백혈병(ALL)환인중적표체급기림상의의。방법입선67례초진ALL환인급10례정상대조인동，채집골수。응용정량RT-PCR방법검측병비교골수중MRP1 mRNA표체수평。결과표위、중위、고위조MRP1 mRNA표체수평분별위4.28(2.75~6.12)、5.62(4.99~8.60)화7.56(3.66~11.13)，삼조간차이유통계학의의(P<0.01)；고위조화중위조적MRP1 mRNA균고우여표위조，차이유통계학의의(P<0.05)。T-ALL조MRP1 mRNA표체수평위7.71(6.49~14.35)，고우B-ALL조적표체수평[5.18(3.89~8.46)]，차이유통계학의의(P<0.01)。고표체조(n=34)제7천발니송예처리민감솔위70.59%，이저표체조(n=33)민감솔위90.91%，차이유통계학의의(P<0.05)。고표체조제33천골수완전완해솔위64.71%，저표체조위87.88%，차이야유통계학의의(P<0.05)。결론ALL환인MRP1표체여면역분형、치료반응이급질병위험정도화복발긴밀상관。
Objective Multidrug resistance-associated protein 1 (MRP1) has been reported with a close correlation with tumor multi-drug resistance. Real-time quantitative PCR (QRT-PCR) was performed to detect the MRP1 gene expression in childhood acute lymphoblastic leukemia (ALL) and its clinical signiifcance was analyzed. Methods Sixty-seven denovo ALL patients and 10 healthier children as bone marrow donor were studied. The chemotherapy was given according to CCLG-2008 protocol. SPSS software was employed to analyze the data and p-value below 0.05 was regarded as statistic signiifcance. Results MRP1 expression level showed a close correlation with ALL risk, the median of MRP1 expression was 4.28 (2.75~6.12), 5.62 (4.99~8.60) and 7.56 (3.66~11.13) for standard-risk group (SR), intermediate-risk group (IR) and high-risk group (HR), respectively. MRP1 mRNA expression in T-ALL group was 7.71 (6.49~14.35), which is higher than that of B-ALL (5.18(3.89~8.46)) (P<0.01). The rate of leukemia cells’ sensitivity to prednisone on 7th day was 70.6%in high expression group (n=34), which was signiifcantly lower than that in low expression group (n=33, 90.9%, P=0.035). The complete remission rateon 33th day was 64.7%in high expression group, and 87.9%in low expression group, which showed a signiifcant difference between them (P=0.026). Conclusions In children ALL, the expression of MRP1 is closely related with immunophenotyping, treatment response, hazard level and disease relapse.