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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 detect the expression of PGP, GST-π, Topo-Ⅱ and LRP in primary ovarian cancer and to provide a new valuable reference index for the selection and prognosis of postoperative chemotherapy regimen in ovarian cancer. Methods: The expressions of PGP, GST-π, Topo-Ⅱ and LRP in 80 cases of ovarian cancer were detected by immunohistochemistry. The relationship between them and the clinicopathological parameters of ovarian cancer was evaluated. Results: The positive rates of PGP, GST-π, Topo-Ⅱ and LRP in ovarian cancer tissues were 57.5%, 58.8%, 76.3% and 73.8%, respectively, which were significantly higher than those in benign tumors and normal tissues (P <0.05). The expression rates of PGP were 40.7% and 66.0% (P <0.05), and those of GST-π were 40.7% and 67.9% (P <0.05) respectively in clinical staging Ⅰ / Ⅱ and Ⅲ / Ⅳ. 66.7% and 81.1%, respectively (P> 0.05). The LRP was 55.6% and 83.0% respectively (P <0.05). The expression of PGP was up to 57.9%, 62.1% and 53.1% (P> 0.05), and the GST-π was 36.8%, 55.2% and 75.0% (P <0.05) Were 52.6%, 79.3% and 87.5%, respectively (P <0.05). The LRP was 84.2%, 69.0% and 71.9%, respectively. The median survival of PGP positive and negative groups was 36 and 48 months (P = 0.001 7), GST-π was 36 and 41 months (P = 0.010 3), Topo-Ⅱ was 37 and 39 months (P = 0.381 1), LRP was 37 and 55 months (P = 0.002 1). The factors affecting the survival of ovarian cancer were clinical stage and PGP, GST-π, LRP expression. The relative risk of death in stage III / IV patients was 9.460 times of those in stage I / II patients. The relative risk of death in patients with positive PGP, GST-π, and LRP was 2.049, 2.452 and 2.609 times, respectively. Conclusion: There is multidrug resistance in primary ovarian cancer. Combined detection is helpful for the selection of postoperative chemotherapeutics and prognosis of patients.