摘要
目的 确定多药耐药基因 (mdr1)、多药耐药相关蛋白基因 (MRP)和DNA拓扑异构酶 (TopoII)诊断急性白血病 (AL)临床耐药的准确性。方法 连续性收集 45例急性白血病患者 ,P -糖蛋白 (Pgp)的表达用单抗UIC2标记的流式细胞仪法测定 ;mdr1、MRP和TopoII的表达用RT PCR方法检测。以临床耐药作为金标准 ,用Receiver OperatingCharacteristic(ROC)曲线下面积 (AUCROC)评价上述指标的准确性 ;在ROC曲线上确定各种指标的最佳临界点 ;用EPINFOR统计软件比较各平行试验的灵敏度。结果 AUCROC:Pgp 0 .842± 0 .0 6 0 ,mdr10 .72 9± 0 .0 79,MRP 0 .739± 0 .0 77,TopoII 0 .5 2 0± 0 .0 87;Pgp、mdr1、MRP和TopoII的最佳临界点分别为 10 %、0 .8、1.0和 0 .9。此时它们的灵敏度 (Se)和特异度 (Sp)分别为Pgp 74%和 82 % ,mdr16 5 %和 86 % ,MRP 6 1%和 86 % ,TopoII 6 5 %和 41% ;Pgp、mdr1和MRP高度表达中 ,耐药组比敏感组显著增多 (P <0 .0 5 )。TopoII两组差别无显著性 ;Pgp和mdr1,Pgp和MRP ,Pgp、mdr1和MRP的平行试验能够提高诊断临床耐药的灵敏度 ;系列试验可以提高特异度。结论 Pgp、mdr1和MRP诊断价值较高 。
Objective To determine the diagnostic value of Pgp, mdr1, MRP and TopoII of multidrug resistance in acute leukemia (AL) patients. Methods 45 cases were sequentially recruited. Flow cytometry using monoclonal antibody UIC2 was used to detect the expression of Pgp. RT PCR was used to detect the expression of mdr1, MRP and TopoII. According to the gold standard of drug resistance, Area Under Receiver Operating Characteristic Curve (AUCROC) was used to assess the accuracy of the four indicators and to determine the cut off point. EPINFOR statistical software was used to compare the sensitivity of the parallel tests. Results AUC ROC of Pgp was 0.842±0.06, mdr1 0.729±0.079, MRP 0.739±0.077, Topo II was 0.52±0.087. The cut off point of Pgp,mdr1,MRP and TopoII were 10%,0.8,1.0 and 0.9, respectively. The sensitivity and specificity were as follows: Pgp 74% and 82%,mdr1 65% and 86%,MRP 61% and 86%,TopoII 65% and 41%. The overexpression of Pgp mdr1 and MRP in the resistant group was significantly more frequent than those in the sensitive one, while the two groups of TopoII showed no difference. The parallel test of Pgp and mdr1,Pgp and MRP,Pgp, mdr1 and MRP could increase the sensitivity. Conclusion The accuracy of Pgp, mdr1 and MRP for diagnosing multidrug resistance is high. Multiple tests can increase the sensitivity and specificity.
出处
《上海医学》
CAS
CSCD
北大核心
2002年第3期138-141,共4页
Shanghai Medical Journal
