P-gp、GST-π和Topo Ⅱ在巨块型宫颈癌中的表达及其与新辅助化疗的关系  

The expression of P-gp,GST-πand Topo Ⅱ and their correlation with neoadjuvant chemotherapy in bulky cervical carcinoma

作　　者：郭慈仁[1] 陈桂林[1] 黄燕玲[1] 陈炜[1] 张风贞[1] 

机构地区：[1]福建省肿瘤医院妇科,福州350014

出　　处：《疑难病杂志》2013年第2期120-123,F0003,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：福建省卫生厅青年课题基金资助项目(No.2010-2-39)

摘　　要：目的探讨P-糖蛋白(P-gp)、谷胱甘肽-S-转移酶-π(GST-π)和拓扑异构酶Ⅱ(TopoⅡ)在巨块型宫颈癌中的表达及其与新辅助化疗疗效的关系。方法收集178例巨块型宫颈癌术后标本,根据术前是否行新辅助化疗(NACT)分为NACT组和单纯手术组,NACT组91例术前行1疗程紫杉醇加顺铂的联合化疗,单纯手术组87例直接手术治疗,应用免疫组化法检测2组标本中P-gp、GST-π和TopoⅡ的表达情况,并分析其表达与各临床病理因素间的关系。结果 (1)与单纯手术组比较,NACT组P-gp阳性表达率升高(P<0.05);GST-π阳性表达率升高,但差异无统计学意义(P>0.05);TopoⅡ阳性表达率降低(P<0.05)。(2)NACT组中P-gp、GST-π阳性表达者化疗有效率明显低于阴性表达者(P<0.05),TopoⅡ阳性表达者化疗有效率高于阴性表达者,但差异无统计学意义(P>0.05)。(3)P-gp、GST-π和TopoⅡ在宫颈癌组织中表达与患者年龄、临床分期、组织学类型、组织学分级、淋巴结转移、脉管癌栓、深肌层浸润、宫旁浸润均无相关性(P均>0.05)。结论新辅助化疗会诱导宫颈癌中P-gp、GST-π和TopoⅡ表达变化,三者联合检测,对新辅助化疗药物选择及疗效预测具有一定参考价值。Objective To investigate the expression of P-gp,GST-tt and TopoⅡand their correlation with neoadjuvant chemotherapy in bulky cervical carcinoma.Methods 178 cases of cervical carcinoma patients in the study were divided into two groups according to pre-operative chemotherapy：91 cases in the NACT group who accepted one course of paclitaxel combined with cisplatin chemotherapy before surgery,another 87 cases in the control group underwent radical surgery directly. Immunohistochemical technique was used to detect the expression of P-gp,GST-tt and TopoⅡin both of the two groups.Correlation between the expression of P-gp,GST-πand TopoⅡ,and the clinical features and pathological features were statistically analyzed at the same time.Results（1 ）The positive expression rate of P-gp in NACT group was significantly higher than which of control group（P 0.05）.The positive expression rate of GST-tt in NACT group was higher than which of control group,while there was no statistical significance（P 0.05 ）.The positive expression rate of TopoⅡin NACT group was significant lower than which of control group（P 0.05 ）.（2） The neoadjuvant chemotherapy effective rate in the case of P-gp, GST-πpositive expression were significant lower than that of patient with P-gp,GST-πnegative expression（P 0.05）.The neoadjuvant chemotherapy effective rate in the case of TopoⅡpositive expression was higher than that of patient with TopoⅡnegative expression,while with no statistical significance（P 0.05）.The expression of P-gp,GST-πand TopoⅡin bulky cervical carcinoma were not correlated with ages,clinical stage,pathological type,pathological grade,lymph node metastasis, vessel invasion,deep stromal invasion and parametrical invasion（P 0.05 ）.Conclusion The results of the experiment suggest that neoadjuvant chemotherapy could affect the expression of P-gp,GST-πand TopoⅡ,which means thal together detected their expression could be used to predict the therapeutic efficacy of neoadjuvant chemotherapy in

关 键 词：宫颈肿瘤 巨块型 P-糖蛋白 谷胱甘肽-S-转移酶 拓扑异构酶Ⅱ 新辅助化疗法 

分 类 号：R737.33[医药卫生—肿瘤]