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目的了解多药耐药相关Ｐ糖蛋白（Ｐｇｐ）是否为初治急性白血病（ＡＬ）完全缓解（ＣＲ）的预后因素。方法对４８例年龄为１５～７０岁未经化疗的初发ＡＬ患者进行前瞻性、截矩性队列研究。ＡＬ诊断和ＣＲ标准按照美、英、法（ＦＡＢ）小组标准。Ｐｇｐ用单克隆抗体ＵＩＣ２标记后经流式细胞仪检测。暴露组和非暴露组分别为Ｐｇｐ阳性和阴性ＡＬ患者。结果变量：经两疗程标准化疗取得ＣＲ的病例数和未缓解病例数。用单因素和多因素逻辑回归分析。结果Ｐｇｐ阴性和阳性组病例数为２５和２３。两组ＣＲ率分别为６８％和２２％。经单因素分析，Ｐｇｐ阴性组较阳性组易取得ＣＲ（ＲＲ＝７．６５，９５％ＣＩ２．１～２８，Ｐ＝０．００２）。年龄、性别、发病时白细胞数、骨髓原＋（早）幼细胞比例和ＦＡＢ分型对ＣＲ无意义。经上述变量校正的多因素分析结果Ｐｇｐ仍对ＣＲ有显著意义（ＲＲ＝９．３，９５％ＣＩ２．２～３９，Ｐ＝０．００２）。Ｐｐｇ对诊断原发耐药白血病的敏感性６９％，特异性７７％，阳性预测值７８％，阴性预测值６８％，阳性似然比３，阴性似然比０．４，患病率５４％，准确性７３％。结论Ｐｇｐ阳性是初治急性白血病完全缓解的不利预后因素。用它可以预测原发耐药急性白血病
Objective To investigate whether multidrug resistance-associated P glycoprotein (Pgp) is a prognostic factor for primary acute leukemia (AL) complete remission (CR). Methods A prospective, truncated cohort study of 48 primary AL patients aged 15 to 70 years without chemotherapy was performed. The AL diagnostic and CR standards are based on the standards of the United States, Britain, and France (FAB) groups. Pgp was labeled with the monoclonal antibody UIC2 and detected by flow cytometry. The exposed and non-exposed groups were Pgp-positive and negative AL patients, respectively. Outcome variables: The number of CR cases and the number of unremitted cases obtained after two courses of standard chemotherapy. Univariate and multivariate logistic regression analysis were used. Results The number of cases with Pgp negative and positive groups was 25 and 23. The CR rates for the two groups were 68% and 22%, respectively. By single-factor analysis, CR was more easily obtained in the negative Pgp group than in the positive group (RR=7.65, 95%CI2.1 to 28, P=0.002). Age, sex, number of white blood cells at the time of onset, promyelocytic + (early) young cell ratio, and FAB typing were not significant for CR. The multivariate analysis corrected by the above variables showed that Pgp was still significant for CR (RR = 9.3, 95%CI2.2-39, P=0.002). Ppg sensitivity to diagnosis of primary drug-resistant leukemia 69%, specificity 77%, positive predictive value of 78%, negative predictive value of 68%, positive likelihood ratio of 3, negative likelihood ratio of 0.4, prevalence rate of 54% Accuracy 73%. Conclusion Pgp positive is an unfavorable prognostic factor for the initial remission of acute leukemia. Use it to predict primary drug-resistant acute leukemia