摘要目的 通过检测慢性粒细胞白血病(CML)骨髓细胞人类有机阳离子转运蛋白1(hOCT1)和三磷酸腺苷结合盒蛋白B亚家族成员1(ABCB1)基因的mRNA表达水平,研究它们对伊马替尼(IM)疗效的影响.方法 对2008年1月至2011年6月诊断并服用IM治疗的CML 90例患者,采用taqman探针实时荧光定量PCR法检测其骨髓细胞中hOCT1及ABCB1基因mRNA的表达,按疗效分为耐药组、部分细胞遗传学缓解(PCyR)组、完全细胞遗传学缓解(CCR)组(n=17、11、62)；按服用IM疗程分为3～6、7～12、13～24、25～48、＞48个月5组(n=21、8、15、29、17).分析两种基因表达水平与疾病不同疗效状态、用药疗程及获得CCR率的关系.结果 CCR组hOCT1 mRNA表达水平(Ig值:-3.77±0.55)高于耐药组(-4.12±0.47)和PCyR组(-4.24±0.35)(P=0.047、0.019)；耐药组ABCB1 mRNA表达水平(-2.93±0.49)高于CCR组(-3.02±0.56)和PCyR组(-3.51±0.45) (P =0.045、0.021).服用IM不同疗程的5组患者间hOCT1、ABCB1表达水平差异均无统计学意义(P=0.270、0.367).中位随访30(3～117)个月,IM治疗相同疗程患者hOCT1、ABCB1低表达组CCR率明显高于高表达组(P=0.006、0.049).结论 IM治疗CML患者hOCT1、ABCB1 mRNA表达水平在疾病不同状态间存在差异,也影响首次获得CCR的时间,但不受治疗疗程的影响.

abstractsObjective To detect the expression of hOCTI and ABCB1 in marrow cells and examine the efficacy of imatinib mesylate (IM) in patients with chronic myelocytic leukemia (CML).Methods hOCT1 and ABCB1 gene in 90 samples with chronic phase CML diagnosed at our hospital from January 2008 and June 2011 were detected by taqman probe real-time reverse transcription-PCR (RT-PCR).The samples were divided into 3 groups:drug-resistant group ( n =17),partial cytological remission (PCyR) group ( n =11 ) and complete cytogenetic remission (CCR) group ( n =62) according to IM efficacy and 3-6,7-12,13-24,25-48,＞48 months five groups ( n =21,8,15,29,17 ) according to IM treatment course.The relationship was explored between two genes and different disease states,course of treatment and time from first CCR.Results The h0CT1 gene mRNA expression of CCR group ( - 3.77±0.55 ) was higher than drug-resistant group ( -4.12±0.47 ) and PCyR group ( -4.24±0.35 ) (P =0.047,0.019).The ABCB1 gene mRNA expression of drug-resistant group ( -2.93±0.49 ) was higher than CCR group ( -3.02±0.56 ) and PCyR group ( -3.51±0.45 ) ( P=0.045,0.021 ).The hOCT1 and ABCB1 mRNA expressions showed no significant difference between five groups divided by IM treatment course ( P =0.270,0.367 ).The median follow-up time was 30( 3-117 ) months.In same IM treatment course patients,the CCR rates in hOCT1 and ABCB1 low-expression groups were higher than that in high-expression groups separately( P =0.006,0.049 ).Conclusions The expression levels of hOCT1 and ABCB1 vary in different disease states of patients on IM.And these two genes may influence the time from first CCR.But there is no significant relationship with course of the treatment.