卵巢癌中P-gp与GST-π的表达对化疗耐药的预测价值  

alue of P-glycoprotein and glutathione S-transferase-π as chemo-resistant indicators in ovarian cancers

作　　者：张帆[1] 漆林涛[1] 陈惠祯[1] 刘诗权[1] 杨庆忆[1] 

机构地区：[1]武汉大学中南医院肿瘤科,武汉430071

出　　处：《中华肿瘤杂志》2001年第4期313-316,共4页Chinese Journal of Oncology

基　　金：湖北省科委重点科技攻关资助项目(951P1602)

摘　　要：目的　探讨卵巢癌内在性的耐药机制及其对化疗反应的影响。方法　运用免疫组织化学方法对 74例术前未经治疗的上皮性卵巢癌进行P 糖蛋白 (P gp)与谷胱甘肽S 转移酶 π(GST π)检测。结果　 (1) 30例正常卵巢组织中 ,P gp与GST π染色无一例阳性 ;而 74例卵巢癌组织中 ,P gp阳性者为 14例 (18 9% ) ,GST π阳性者为 5 5例 (74 3% ) ,这两种指标的表达具有显著的相关性 (P <0 .0 1)。(2 )P gp与GST π的表达与临床分期、组织学类型及细胞分级等临床病理参数均无相关性 (P均 >0 .0 5 )。(3)对首次术后有残余病变的 2 7例患者进行化疗评价 ,P gp阳性组与阴性组对化疗的反应率为 0及 5 7 1% ,两组比较 ,差异有显著性 (P <0 .0 5 ) ;P gp阳性对耐药的预测值为 10 0 % ,P gp阴性对化疗反应的预测值为 5 7 1%。GST π阳性组与阴性组对化疗的反应率为 13 3 %和 83 3% ,两组比较 ,差异有显著性 (P <0 .0 1)。GST π阳性对耐药的预测值为 86 7% ,GST π阴性对化疗反应的预测值为 83 3%。 (4 )P gp与GST π阳性组的生存率也显著低于阴性组 (P <0 .0 1,P <0 .0 5 )。结论　术前未经治疗的卵巢癌中在一定程度上存在着由P gp与GST π介导的内在性的耐药机制 ,P gp与GST π的表达能较好地预测化疗反应及耐药 ,对预后也?Objective This study was conducted to assess the predictive value of P glycoprotein (P gp) and glutathione S transferase π(GST π) as indicators of resistance to chemotherapy in ovarian cancers. Methods Expressions of P gp and GST π were immunohistochemically studied in paraffin sections from 30 normal ovaries and 74 resected specimens of primary epithelial ovarian cancer from patients who had not received any chemotherapy before surgery. Results There were no detectable P gp or GST π expression in the 30 patients with normal ovaries. In 74 cases of ovarian cancer tissue, P gp was positive in 14 (18.9%) and GST π positive in 55 (74.3%) showing a highly significant correlation ( P <0.01). However, expression of P gp and GST π was not associated with any of the clinicopathological parameters, such as clinical stage, histologic type or tumor grade ( P >0.05). The evaluation of chematherapy for postoperative residual ovarian cancer patients showed that all the six lesions showing P gp positive were drug resistant whereas only nine of the twenty one tumors showing negative results were drug resistant. Of 27 clinically measurable resected lesions, this difference in the response rates of the two groups was signficant ( P <0.05). The predictive value of positive P gp stain for drug resistance was 100%(6/6), and that of negative stain for objective responders was 57.1%(12/21). The response rate to chemotherapy of the GST π positive group (13.3% 2/15) was significantly lower than that of the SGT π negative group (83.3% 10/12, P <0.01). The predictive value of postitive GST π stain for drug resistance was 86.7%(13/15) and that of negative stain for objective responders was 83.3%(10/12). The survival rates of P gp negative and GST π negative tumor patients were significantly higher than those of P gp positive and GST π positive tumor patients ( P <0.01, P <0.05, respectively). Conclusion These data suggest that P gp and GST π expression in tumor cells are relat

关 键 词：卵巢肿瘤/药物疗法 P糖蛋白 谷胱甘肽S转移酶Π 

分 类 号：R737.31[医药卫生—肿瘤]