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目的:研究卵巢癌中拓扑异构酶Ⅱα(topoisomeraseα,TopoⅡα)、谷胱甘肽S转移酶π(glutathioneStranserasesπ,GSTπ)、P糖蛋白(Pglycoproein,Pgp)的表达与化疗反应性及预后的关系。方法:采用免疫组化SP法,计算机图象分析技术对80例卵巢癌、20例良性上皮性卵巢肿瘤、20例正常卵巢组织中TopoⅡα、GSTπ、Pgp的表达进行检测。结果:GSTπ、Pgp阳性组患者的化疗反应率显著低于阴性组(分别为51.60%vs88.90%;43.80%vs70.80%,P<0.05)。GSTπ、Pgp阳性对耐药的预测值为48.40%、56.20%;GSTπ、Pgp阴性对化疗反应的预测值为88.90%、70.80%。TopoⅡα阴性而GSTπ、Pgp阳性组以及TopoⅡα阳性而GSTπ、Pgp阴性组患者的化疗反应率分别为33.30%、100.00%,前者显著低于后者(P<0.05)。GSTπ、Pgp阳性组患者术后生存时间均显著短于阴性组(P<0.05,P<0.01)。TopoⅡα阴性而GSTπ、Pgp阳性组患者的术后生存时间显著短于TopoⅡα阳性而GSTπ、Pgp阴性组(P<0.01),Cox多因素分析表明Pgp的表达是影响术后生存的独立因素。结论:TopoⅡα、GSTπ、Pgp的联合检测对合理制定化疗方案、预测化疗反应性及估计预后具有积极的指导意义。
OBJECTIVE: To investigate the relationship between the expression of topoisomeraseα (TopoⅡα), glutathionetransferases π (GSTπ) and Pglycoproein (Pgp) in ovarian cancer and its response to chemotherapy and its prognosis. Methods: The expression of TopoⅡα, GSTπ and Pgp in 80 cases of ovarian cancer, 20 cases of benign epithelial ovarian tumor and 20 cases of normal ovarian tissue were detected by immunohistochemical SP method and computer image analysis technique. Results: The response rate of GSTπ and Pgp positive patients was significantly lower than that of negative patients (51.60% vs88.90%, 43.80% vs70.80%, P <0.05). The predicted values of GSTπ and Pgp positive were 48.40% and 56.20%, respectively. The predicted values of GSTπ and Pgp negative were 88.90% and 70.80% respectively. TopoⅡα negative, GSTπ, Pgp positive group and TopoⅡα positive GSTπ, Pgp negative patients chemotherapy response rates were 33.30%, 100.00%, the former was significantly lower than the latter (P <0.05). The survival time of GSTπ and Pgp positive patients was significantly shorter than that of negative patients (P <0.05, P <0.01). The survival time of patients with TopoⅡα negative and GSTπ, Pgp positive was significantly shorter than that of TopoⅡα and GSTπ, Pgp negative (P <0.01). Cox multivariate analysis showed that the expression of Pgp was an independent factor affecting the postoperative survival. Conclusion: The combined detection of TopoⅡα, GSTπ and Pgp has a positive guiding significance in the rational formulation of chemotherapy regimen, predicting the response to chemotherapy and estimating the prognosis.