卵巢肿瘤组织MTRR蛋白表达检测及其临床意义

Detection Protein Overexpression of 5-Methyltetrahydrofolate-homocysteine Methyltransferase Reductase and Its Clinical Significance in Ovarian Carcinomas

目的探讨卵巢恶性肿瘤组织中亚甲基四氢叶酸—高半胱氨酸甲基转移还原酶(MTRR)的表达及其临床意义。方法采用Western blot检测80例卵巢恶性肿瘤组织、50例卵巢良性肿瘤组织及40例正常卵巢组织中的MTRR表达情况,分析其与卵巢恶性肿瘤临床病理及多药耐药的相关性。结果 (1)MTRR在卵巢正常组织、卵巢良性肿瘤和卵巢恶性肿瘤中的表达量依次增高(P<0.05)。(2)MTRR在卵巢恶性肿瘤临床分期中Ⅰ～Ⅱ期的表达量低于Ⅲ～Ⅳ期,在组织分级高分化中的表达量低于中低分化(P<0.05)。(3)MTRR在铂类药物耐药型卵巢恶性肿瘤中的表达量高于铂类药物敏感型(P<0.05);在治疗后肿瘤进展者中的表达量高于缓解者(P<0.01)。(4)MTRR在黏液性肿瘤中的表达量低于浆液性肿瘤(P<0.05),在远处器官转移的恶性卵巢肿瘤中高于未有转移者(P<0.01),与患者是否有大网膜转移和腹水量多少无明显相关(P>0.05)。(5)MTRR表达量判断卵巢肿瘤性质的ROC曲线Youden指数最大值为0.681,卵巢恶性肿瘤MTRR表达量的高低与中位生存时间长短差别无明显相关(P>0.05),Cox模型多因素分析显示MTRR表达量不是影响患者生存预后的独立因素。结论 MTRR蛋白过表达与卵巢恶性肿瘤的发生发展相关,MTRR蛋白过表达可作为判断肿瘤性质和铂类多药耐药潜在标志物之一。

Objective To explore the protein overexpression of 5 methyltetrahydrofolate-homocysteine methyltransferase reductase（MTRR） and its clinical significance in ovarian carcinomas. Methods West- ern blot analysis was used to detect the expression levels of MTRR in 80 ovarian carcinomas,50 benign o- varian tumors and 30 normal ovarian tissues and its association with clinical pathology and multi-drug re- sistance of ovarian carcinomas was analyzed. Results （1）The expression levels of MTRR increased or- derly in normal ovarian tissues, benign ovarian tumors and ovarian carcinomas, and the difference was sta- tistically significant（P〈0. 05）. （2） For ovarian carcinomas, the expression levels of MTRR in clinical stage Ⅰ-Ⅱ and well-differentiated were lower than that in stage Ⅲ-Ⅳ and poor-differentiated. The differences were both statistically significant （P〈0. 05）. （3）The MTRR expression levels in patients with the platinum-resistant were more than that in the platinum sensitive （P〈0.05）. After chemotherapy the MTRR levels of progressive ovarian carcinomas were higher than those in remission（P〈0. 01 ）. （4）The MTRR expression levels in the mucinous type were lower than that in the serous type（P〈 0.05）. The MTRR levels of ovarian carcinomas with distant organs metastasis were higher than those without metastasis. However, the MTRR levels had no significant association with amounts of ascites and omentum metastasis （P〉 0.05）. （5）Youden index of ROC curve was 0. 681 and the MTRR protein ex- pression was not obvious correlation with median survival time （P〉0.05）. Cox multivariate analysis also showed that the MTRR protein expression level was not an independent prognostic factor. Conclusion The MTRR protein overexpression were association with generation and progress of ovarian carcinomas;as well as the MTRR protein overexpression could be a potential new biomarker for evaluating of ovarian tumor nature and ovarian carcinomas platinum-multi-drug resistance.