原发性卵巢癌多药耐药性及其与预后相关性的研究  

Correlation between multidrug resistance and prognosis in primary ovarian carcinoma

作　　者：卢丹 王志学 顾学文 

机构地区：[1]扬州大学临床医学院妇产科,江苏扬州225001 [2]扬州大学临床医学院病理科,江苏扬州225001

出　　处：《中华肿瘤防治杂志》2009年第22期1789-1792,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的:检测PGP、GST-π、Topo-Ⅱ和LRP在原发性卵巢癌组织中的表达状况,为卵巢癌术后化疗方案的选择和预后判断提供新的有价值的参考指标。方法:采用免疫组化技术检测80例卵巢癌组织中PGP、GST-π、Topo-Ⅱ和LRP的表达,评价其与卵巢癌临床病理参数的关系和预后。结果:PGP、GST-π、Topo-Ⅱ、LRP在卵巢癌组织中阳性表达率分别为57.5%、58.8%、76.3%和73.8%,均高于良性肿瘤和正常组织对照组,P<0.05。临床分期Ⅰ/Ⅱ和Ⅲ/Ⅳ期中,PGP的表达率为40.7%和66.0%(P<0.05),GST-π的为40.7%和67.9%(P<0.05),To-po-Ⅱ的为66.7%和81.1%(P>0.05),LRP的为55.6%和83.0%(P<0.05)。随分化程度由高到低,PGP的表达率为57.9%、62.1%和53.1%(P>0.05),GST-π的为36.8%、55.2%和75.0%(P<0.05),Topo-Ⅱ的为52.6%、79.3%和87.5%(P<0.05),LRP的为84.2%、69.0%和71.9%(P>0.05)。PGP阳性与阴性组中位生存期为36和48个月(P=0.001 7),GST-π为36和41个月(P=0.010 3),Topo-Ⅱ为37和39个月(P=0.381 1),LRP为37和55个月(P=0.002 1)。影响卵巢癌生存因素分别为临床分期和PGP、GST-π、LRP的表达。临床Ⅲ/Ⅳ期的患者相对死亡风险度为Ⅰ/Ⅱ期患者的9.460倍,PGP、GST-π、LRP阳性患者相对死亡风险度分别是阴性表达患者的2.049、2.452和2.609倍。结论:原发性卵巢癌存在多药耐药,联合检测有助于遴选术后化疗药物,并预测患者的生存和预后。OBJECTIVE： To investigate the expression of the multidrug resistance-associated biomarkers PGP,GST-π,Topo-Ⅱ and LRP in ovarian carcinoma,thus providing better chemotherapy choice and post-operative prognosis for ovarian carcinoma patients.METHODS： Immunohistochemistry was used to detect the expression of PGP,GST-π,Topo-Ⅱ and LRP in 80 specimens of primary ovarian carcinoma.The results were analyzed by correlation with clinical pathological parameters.RESULTS： The positive expression rates of PGP,GST-π,Topo-Ⅱ and LRP in ovarian carcinoma（57.5%,58.8%,76.3% and 73.8%,respectively） were all higher than those in normal and benign tissues（P〈0.05）.In clinical stages Ⅰ/Ⅱ vs Ⅲ/Ⅳ,the expression rates of PGP,GST-π,Topo-Ⅱ and LRP were 40.7% vs 66.0%（P〈0.05）,40.7% vs 67.9%（P〈0.05）,66.7% vs 81.1%（P〉0.05）,and 55.6% vs 83.0%（P〈0.05）,respectively.The differentiation degree in the carcinoma tissues ranged from high to low levels,and the expression levels of each marker were： PGP,57.9%,62.1% and 53.1%（P〉0.05）;GST-π,36.8%,55.2% and 75.0%（P〈0.05）;Topo-Ⅱ,52.6%,79.3% and 87.5%（P〈0.05）;and LRP,84.2%,69.0% and 71.9%（P〉0.05）.PGP,GST-π,Topo-Ⅱ and LRP positive expression in patients had a shorter median survival time（36,36,37 and 37 months） than those with negative expression（48,41,39 and 55 months）,P=0.001 7,P=0.010 3,P=0.381 1,P=0.002 1.The relative death risk for patients with clinical stage Ⅲ/Ⅳ tumors increased 9.460-fold compared to those with stage Ⅰ/Ⅱ tumors.The relative death risk in the PGP,GST-π and LRP positive groups increased by 2.049-,2.452-or 2.609-fold,respectively,compared with the corresponding negative groups.CONCLUSION： Combined evaluation of PGP,GST-π,Topo-Ⅱ and LRP expression may better enable chemotherapeutic choice,and provide an accurate prognosis for ovarian carcinoma patients.

关 键 词：卵巢肿瘤/病理学 抗药性 多药 P糖蛋白类 谷胱甘肽转移酶 DNA拓扑异构酶类 Ⅱ型 预后 

分 类 号：R737.31[医药卫生—肿瘤]