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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 To investigate the intrinsic resistance mechanism of ovarian cancer and its effect on chemotherapy response. Methods Immunohistochemistry was used to detect the expressions of P-gp and GST π in 74 cases of preoperative untreated epithelial ovarian cancer. Results (1) None of the 30 cases of normal ovarian tissue had positive Pgp and GST π staining. In 74 cases of ovarian cancer, 14 cases (18.9%) were positive for P gp and 55 cases were positive for GST π (74.3%). There was a significant correlation between the two indicators (P <0.01). (2) There was no correlation between the expression of P gp and GST π and clinicopathological parameters such as clinical stage, histological type and cell grade (all P> 0.05). (3) Chemotherapy was evaluated in 27 patients with residual disease after the first postoperative operation. The response rate of chemotherapy to Pgp positive group and negative group was 0 and 57.1%, respectively. There was significant difference between the two groups (P < 0.05). The predicted value of P gp positive for drug resistance was 100%, while the negative value of P gp for chemotherapeutic response was 57.1%. The reaction rates of GST π positive group and negative group to chemotherapy were 13 3% and 83 3%, respectively. There was significant difference between the two groups (P <0.01). The predicted value of GST π positive drug resistance was 86.7%, and the negative value of GST π negative response to chemotherapy was 83.3%. (4) The survival rates of P gp and GST π positive group were also significantly lower than those of negative group (P <0.01, P <0.05). Conclusions There is a mechanism of resistance mediated by P gp and GST π to some extent in untreated ovarian cancer. The expression of P gp and GST π can predict the response of chemotherapy and drug resistance well, The prognosis is also?