急性白血病细胞P-糖蛋白和CD<sub>34</sub>的表达与患者化疗预后的相关性-现代医学

急性白血病细胞P-糖蛋白和CD₃₄的表达与患者化疗预后的相关性

单位：1. 东南大学医学院, 江苏南京 210009;
2. 常州市第一人民医院血液科, 江苏常州 213000;
3. 东南大学附属中大医院血液科, 江苏南京 210009

分类号：R733.71

出版年·卷·期（页码）：2018·46·第六期（664-669）

摘要：

目的：探讨急性白血病（AL）患者P-糖蛋白（P-gp）、CD₃₄表达与患者化疗预后的相关性。方法：收集2015年1月至2017年12月东南大学附属中大医院血液科和常州市第一人民医院血液科AL患者的实验室检测指标和临床资料39份。按照FBA标准及白血病免疫学分型诊断为急性淋巴细胞白血病（ALL）和急性髓细胞性白血病（AML）两大类。根据39例AL患者骨髓细胞中P-gp和CD₃₄表达的流式细胞术检测结果，以患者P-gp表达≤ 2%（或>2%）和CD₃₄表达≤ 30%（或>30%）分组，探讨急性白血病细胞P-gp和CD₃₄表达与患者化疗预后的相关性。结果：P-gp ≤ 2%组患者化疗后完全缓解率高于P-gp>2%组，且两组之间差异有统计学意义（P<0.05）；CD₃₄表达≤ 30%组患者化疗后完全缓解率高于CD₃₄表达>30%组，但两组差异无统计学意义（P>0.05）。结论：P-gp表达检测对AL患者的化疗后完全缓解率评估有较大意义，但尚不能认为CD₃₄表达检测对AL患者的化疗后完全缓解率评估有较大意义。

Objective:To study the relationship between datum of P-gp/CD₃₄ and the results of chemotherapy prognosis of patients with acute leukemia (AL). Methods:Laboratory indexes and clinical data of 39 patients with AL were collected from January 2015 to December 2017 in the Department of Hematology, Zhongda Hospital, Southeast University or the First People's Hospital of Changzhou. AL was divided into two categories according to the FBA standard and leukemia immune classification, including acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). According to the expression of p-gp (≤ 2%) or CD₃₄(≤ 30%) by Flow cytometry,the patients were divided into two group. The relationship of the expression of P-gp/CD₃₄ with the prognosis of AL patients was studied after chemotherapy between two groups. Results:The complete remission(CR) rate was higher in the patients of P-gp ≤ 2% group than in P-gp>2% group, and there was a significant difference between two groups (P<0.05).Conclusion:Measurement of p-gp may be more valuable to evaluate the prognosis of patients with AL, whereas the measurement of CD₃₄ may be not sufficient to evaluate the prognosis of patients with AL.

参考文献：

[1] LOWENBERG B,ROWE J M.Introduction to the review series on advances in acute myeloid leukemia(AML)[J].Blood,2016,127(1):1.
[2] SOULIERJ,CORTES J.Introduction to the review series on acute lymphoblastic leukemia[J].Blood,2015,125(26):3965-3966.
[3] 张有为,邓红,陈平圣,等.成纤维细胞与大肠癌细胞相互作用对大肠癌细胞表达EMM PRN的影响[J].现代医学,2007,3(3):174-177.
[4] YANG M H,ZHAO M Y,HE Y L,et al.Interaction of WAVE1 and genes involved in multiple drug resistance in children with acute myeloblastic leukemia[J].Chin J Pediatr,2010,48(3):175-179.
[5] MAHJOUBI F,AKBARI S.Multidrug resistance-associated protein 1 predicts relapse in Iranian childhood acute lymphoblastic leukemia[J].Asian Pac J Cancer Prev,2012,13(5):2285-2289.
[6] XIA C Q,SMITH P G.Drug efflux transporters and multidrug resistance in acute leukemia:therapeutic impact and novel approaches to mediation[J].Mol Pharmacol,2012,82(6):1008-1021.
[7] van den HEUVEL-EIBRINK M M,WIEMER E A,de BOEVERE M J,et al.MDR1 gene-related clonal selection and P-glycoprotein function and expression in relapsed or refractory acute myeloid leukemia[J].Blood,2001,97(11):3605-3611.
[8] JIANG Z,WU D,LIN S,et al.CD34 and CD38 are prognostic biomarkers for acute B lymphoblastic leukemia[J].Biomark Res,2016,4(23):1-4.
[9] PUI C H,HANCOCK M L,HEAD D R,et al.Clinical significance of CD34 expression in childhood acute lymphoblastic leukemia[J].Blood,1993,82(3):889-894.
[10] PATEL C,STENKE L,VARMA S,et al.Multidrug resistance in relapsed acute myeloid leukemia:evidence of biological heterogeneity[J].Cancer,2013,119(16):3076-3083.
[11] BRECCIA M,de PROPRIS M S,STEFANIZZI C,et al.Negative prognostic value of CD34 antigen also if expressed on a small population of acute promyelocytic leukemia cells[J].Ann Hematol,2014,93(11):1819-1823.
[12] CASCAVILLA N,MUSTO P,D'ARENA G,et al.Adult and childhood acutelymphoblastic leukemia:clinico-biological differences based on CD34 antigen expression[J].Haematologica,1997,82:31-37.
[13] 樊娟,张丽,刘思管,等.急性白血病细胞P-gp LRP的表达及其临床意义[J].中国肿瘤临床,2007,34(7):374-376.
[14] GERBER J M,SMITH B D,NGWANG B,et al.A clinically relevant population of leukemic CD34(+)CD38(-) cells in acute myeloid leukemia[J].Blood,2012,119(15):3571-3577.
[15] SCHEINER M A,CUNHA-VASCONCELOS F,MATTA R R,et al.ABCB1 genetic variation and P-glycoprotein expression/activity in a cohort of Brazilian acute myeloid leukemia patients[J].J Cancer Res Clin Oncol,2012,138:959-969.
[16] ROSE-INMAN H,KUEHL D.Acute leukemia[J].Emerg Med Clin North Am,2014,32(3):579-596.
[17] 焦庆嵩,杜明华.放射性核素标记多功能纳米系统在恶性肿瘤诊治中的应用[J].东南大学学报:医学版,2017,36(6):1044-1048.
[18] 侯亮,冯海利.脑胶质瘤组织中P-gp、MRP、BCRP的表达及临床意义[J].中国医药导报,2017,14(35):12-15.
[19] XIA C Q,SMITH P G.Drug efflux transporters and multidrug resistance in acute leukemia:therapeutic impact and novel approaches to mediation[J].Mol Pharmacol,2012,82(6):1008-1021.
[20] 潘树矿,方梅.P-gp170和ki-67在口腔鳞癌中的表达[J].中华全科医学,2014,12(7):1068-1070.
[21] 廉蕊,刘少卿,郑纪宁,等.多药耐药基因相关产物P-gp和Topo-Ⅱ在结直肠癌中的表达及临床意义[J].中国医学装备,2018,15(3):83-85.
[22] de MORAES A C,MARANHO C K,RAUBER G S,et al.Importance of detecting multidrug resistance proteins in acute leukemia prognosis and therapy[J].J Clin Lab Anal,2013,27(1):62-71.
[23] 张军红,李青,王春华,等.恶性肿瘤干细胞标记物CD34在鼻咽癌细胞系的表达[J].中国组织工程研究,2016,20(23):3374-3379.
[24] 李学春,许江燕,陶茂灿,等.复方丹参注射液联合伊马替尼对急性淋巴细胞白血病患者P-糖蛋白、P53蛋白水平及心血管功能的影响[J].中华中医药学刊,2017,35(2):425-428.
[25] 彭仲华,梁亮科.CD34、MMP-9、VEGF、PCNA在骨巨细胞瘤中的表达及临床意义[J].中国骨科临床与基础研究杂志,2017,9(6):349-354.
[26] JUNCA J,GARCIA O,GARCIA-CARO M,et al.CD34 expression and the outcome of nucleophosmin 1-mutated acute myeloid leukemia[J].Ann Hematol,2016,95(12):1949-1954.
[27] SVIEZHENTSEVA I O,PEREKHRESTENKO T P,BILKO D I,et al.Functional activity of CD34-positive cells in chronic myeloid leukemia patients with different response to imatinib therapy[J].Exp Oncol,2015,37,(1):70-72.

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