大约40%的弥漫性大B细胞淋巴瘤（DLBCL）患者对一线R-CHOP方案出现治疗抗性。ATP结合盒（ABC）转运蛋白和生存因子可能在各种肿瘤的多药耐药性（MDR）中起到一定作用。本研究旨在调查ABC转运蛋白和生存因子的共表达是否与R-CHOP治疗反应有关。使用免疫组化分析从DLBCL患者获取的肿瘤标本中的Bcl-2、survivin、P-糖蛋白/ABCB1、MRP1/ABCC1和BCRP/ABCC2的表达情况，并根据治疗反应分为缓解、复发和（原发）难治组。所有患者接受了R-CHOP或等效治疗。Bcl-2与临床参数和除P-gp/ABCB1以外的所有生物标记物呈强正相关。MRP1/ABCC1、survivin和BCRP/ABCC2的过表达，即高免疫反应评分（IRS），分别检测到难治组和复发组（p < 0.05 vs 缓解）。而P-gp/ABCB1的IRS值较低。在难治组和复发组中，MRP1/ABCC1与survivin或BCRP/ABCC2之间存在显著相关性。在多元线性回归分析中，ECOG状态与MRP1/ABCC1或survivin以及BCRP/ABCG2显著相关，可预测R-CHOP治疗反应。DLBCL可能具有某些分子特征，如MRP1/ABCC1、survivin和BCRP/ABCC2的过表达，可预测对R-CHOP的耐药性。

Approximately 40% of patients with diffuse large B-cell lymphoma (DLBCL) experience treatment resistance to the first-line R-CHOP regimen. ATP binding cassette (ABC) transporters and survivin might play a role in multidrug resistance (MDR) in various tumors. The aim was to investigate if the coexpression of ABC transporters and survivin was associated with R-CHOP treatment response.The expression of Bcl-2, survivin, P-glycoprotein/ABCB1, MRP1/ABCC1, and BCRP/ABCC2 was analyzed using immunohistochemistry in tumor specimens obtained from patients with DLBCL, and classified according to the treatment response as Remission, Relapsed, and (primary) Refractory groups. All patients received R-CHOP or equivalent treatment.Bcl-2 was in strong positive correlation with clinical parameters and all biomarkers except P-gp/ABCB1. The overexpression of MRP1/ABCC1, survivin, and BCRP/ABCC2 presented as high immunoreactive scores (IRSs) was detected in the Refractory and Relapsed groups (p < 0.05 vs. Remission), respectively, whereas the IRS of P-gp/ABCB1 was low. Significant correlations were found among either MRP1/ABCC1 and survivin or BCRP/ABCC2 in the Refractory and Relapsed groups, respectively. In multiple linear regression analysis, ECOG status along with MRP1/ABCC1 or survivin and BRCP/ABCG2 was significantly associated with the prediction of the R-CHOP treatment response.DLBCL might harbor certain molecular signatures such as MRP1/ABCC1, survivin, and BCRP/ABCC2 overexpression that can predict resistance to R-CHOP.