Glucocorticoid Receptor in Lymphocytic Malignancies.

Objective To determine the level of glucocorticoid(GC) receptor (GR) at the membrane and cytoplasma of lymphocytic malignancy cell. To study the relationship among clinical characters, membrane glucocorticoid receptor (mGR) and cytoplasma glucocorticoid receptor (cGR).

Methods The expression level of membrane glucocorticoid receptor (mGR) and cytoplasma glucocorticoid receptor (cGR) at lymphocyte from 51 patients with lymphocytic malignancies, 19 patients with acute myelogenous leukemia (AML) and 22 normal children were measured by flow cytometry. The levels and relationship of mGR and cGR in different diseases, in 3 ALL risk groups, in both poor and good early clinical response groups to prednision in children with ALL, are analyzed.

Results There were no significant differences among the expression of mGR in lymphocytic malignancies, AML and normal group. However, significant increase of cGR expression was observed in lymphocytic malignancies when compared with AML and normal group(P<0.001). Of the 51 lymphocytic malignancies cases, 17 were diagnosed as high risk (HR), 30 as medium risk (MR), and 4 as low risk (LR). There were no significant differences among the expression of mGR in HR, MR and LR group[75.06 (15.51~377.14)vs. 69.89(8.31~527.60)vs.29.64 (28.53~ 571.19); P>0.05]. Significant decrease of cGR expression was observed in HR when compared with MR and LR group[63.57(28.39~473.29)vs.107.78(53.60~545.46)vs.348.67(53.79~582.33);P<0.01]. Of the 47 ALL cases, 42 had good response to predinisone(day 8, pGR), 5 poor response(ppR). There were no significant differences between the expression of mGR in pGR and ppR group[71.60(10.83~529.47)vs. 38.34(15.51~69.81);P>0.05]. But the expression of cGR was significantly increased in pGR group when compared with ppR group[100.76(39.77~580.47)vs. 45.09(28.39~64.05);P<0.01]. Of the 51 lymphocytic malignancies cases, 40 had complete response to early combined chemotherapy(day 19) and 11 had partial or no response. There were no significant differences between the expression of mGR in complete response and resistance group [74.19(10.07~501.94)vs. 66.21(15.51~590.01);P>0.05]. However, the expression of cGR was significantly increased in complete response group when compared with resistance group[107.78(53.83~583.44)vs. 54.10(28.39~430.26);P<0.01].

Conclusion In acute lymphoblastic leukenia, the expression of cGR was positively related to the risk group, the early response to therapy and may work as a predictor for evaluation of prognosis.