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目的探讨耐药相关基因基因在复发难治性非霍奇金淋巴瘤(NHL)中的表达及其临床意义。方法用免疫组织化学SP法检测60例复发难治性NHL患者P-糖蛋白(P-gp)、谷胱甘肽转移酶-π(GST-π)、Bcl-2和DNA拓扑异构酶Ⅱ(TopoⅡ)蛋白表达,分析其与NHL化疗疗效及预后的关系。结果复发难治性NHL患者的P-gp、GST-π、Bcl-2和TopoⅡ蛋白表达分别为68.3%、61.7%、45.0%和48.3%。P-gp、GST-π和Bcl-2的表达与临床分期相关(P<0.05);TopoⅡ的表达与观测临床参数无相关性(P>0.05)。与寡耐药基因表达组(1种或无耐药基因表达,17例)NHL比较,多耐药基因表达组(≥2种耐药基因表达,43例)化疗有效率(37.2%vs.70.6%)和生存率较低(P<0.05和P<0.01)。结论检测P-gp、GST-π、Bcl-2和TopoⅡ蛋白表达可作为NHL患者化疗疗效的预测指标,有助于选择相应的化疗药物,实施个体化治疗。
Objective To investigate the expression and clinical significance of resistance-related gene in relapsed and refractory non-Hodgkin’s lymphoma (NHL). Methods The expressions of P-gp, GST-π, Bcl-2 and DNA topoisomerase Ⅱ in 60 patients with refractory NHL were detected by immunohistochemical SP method (Topo Ⅱ) protein expression, analysis and NHL chemotherapy efficacy and prognosis. Results The expressions of P-gp, GST-π, Bcl-2 and TopoⅡ in patients with recurrent refractory NHL were 68.3%, 61.7%, 45.0% and 48.3%, respectively. The expressions of P-gp, GST-π and Bcl-2 were correlated with clinical stage (P <0.05). There was no correlation between TopoⅡ expression and clinical parameters (P> 0.05). Compared with the NHL of oligo-resistant gene expression group (1 or no resistance gene expression, 17 cases) NHL, the multi-drug resistance gene expression group (≥2 resistance gene expression, 43 cases) chemotherapy efficiency (37.2% vs.70.6 %) And survival rate was lower (P <0.05 and P <0.01). Conclusion Detecting the expression of P-gp, GST-π, Bcl-2 and TopoⅡ can be used as predictors of chemotherapeutic effect in patients with NHL. It is helpful to select appropriate chemotherapeutic agents and implement individualized therapy.