65例早期宫颈癌耐药基因产物与临床预后关系的初步探讨

目的:探讨耐药基因产物P-糖蛋白(P-gp)、谷胱甘肽-s-转移酶(GST-π)、拓扑异构酶Ⅱ(TopoⅡ)、胸苷酸合成酶(TS)在宫颈癌中的表达及临床意义.方法:应用免疫组织化学方法检测65例宫颈癌中P-gp、TopoⅡ、GST-π、TS的表达,并分析其与临床预后之间的关系.结果:P-gp的表达与肿瘤分化程度、淋巴结转移有关(P<0.05),与UICC分期、局部复发无关(P>0.05);TopoⅡ的表达与淋巴结转移、局部复发有关(P<0.05),与肿瘤分化程度、UICC分期无关(P>0.05);GST-π的表达与各个指标之间均有关(P<0.05);TS与淋巴结转移、UICC分期有关(P<0.05),与局部复发、肿瘤分化无关(P>0.05)。经多因素Cox比例风险模型分析显示:局部复发、淋巴结转移及TopoⅡ、GST-π的表达与宫颈癌患者术后生存率有关(P<0.05)。结论:联合检测宫颈癌中P-gp TopoⅡ、GST-π、TS对判断宫颈癌的预后十分必要;局部复发、淋巴结转移及TopoⅡ、GST-π的表达可作为宫颈癌患者独立的预后因素。

A preliminary study of drug resistance protein expressions and their clinical significance in early cervical carcinoma

Objective:To investigate the expression of Pglycoprotein(P-gp),glutathione-s-transferase-π(GST-π),Topo isomerase Ⅱ(TopoⅡ) and thymidylate synthase(TS)and clinical significance in cervical carcinoma.Methods:The expression of P-gp,TopoⅡ,GST-π,TS proteins were detected by immmunohistochemistry method in sixty-five patients with cervical carcinoma who were followed up more than ten years.The relationship between the expression of drug resistance proteins and clinical prognosis were analysed.Results:The expression of P-gp was associated with lymph node metastasis and histological grading(P<0.05),was not associated with recurrence,UICC staging(P>0.05).The expression of TopoⅡ was associated with lymph node metastasis and recurrence(P<0.05),was not associated with histological grading,UICC staging(P>0.05).The expression of GST-π was associated with all parameters(P<0.05).The expression of TS was associated with lymph node metastasis and UICC grading(P<0.05),was not associated with recurrence,histological staging(P>0.05).In the multivariate Cox analysis,survival rate was correlated with recurrence,lymph node metastasis,TopoⅡand GST-π(P<0.05).Conclusion:The detection of the drug resistance genes P-gp,TopoⅡ,GST-π and TS have an important clinical significence for the selection of chemotherapy regimen;recurrence,lymph node metastasis and the expression of GST-π and TopoⅡ can be regarded as independent prognostic factors in cervical carcinoma.