GST-π、TopoⅡα在口腔鳞状细胞癌不同区域中的表达差异和临床意义

The clinical significance of expression of glutathion-s-transferases-π and topoisomerase Ⅱα in different parts of oral squamous cell carcinoma

目的研究口腔鳞状细胞癌的手术切除标本不同区域耐药基因产物GST-π、TopoⅡα的表达差异及其临床意义。方法运用免疫组化方法检测20例未经化疗和19例经诱导化疗的口腔鳞状细胞癌石蜡标本,分表层区和深层浸润区观察GST-π、TopoⅡα的表达。结果GST-π,TopoⅡα阳性表达在20例未经化疗的标本表层区分别为18例(90%),15例(75%),深层浸润区分别为15例(75%),1例(5%);在19例经诱导化疗的标本表层区分别为16例(84.21%),18例(94.74%);深层浸润区分别为12例(63.16%),8例(42.11%)。两组中GST-π、TopoⅡα的阳性表达在表面区和深层区之间均有显著性差异(P<0.05)。而在有否经化疗两组间,GST-π只在深层浸润区的阳性表达有显著性差异(P<0.05),TopoⅡα在表层区及深层区的阳性表达则均有显著性差异(均为P<0.05)。GST-π,TopoⅡα的表达与患者性别、年龄、病理分级、临床分期、肿瘤生长部位、三年无瘤生存期和化疗效果无明显相关。结论口腔鳞状细胞癌在耐药基因和相关蛋白方面存在着异质性;诱导化疗可产生肿瘤的耐药性变化,这对诱导化疗和辅助化疗的选择有一定的指导意义;GST-π,TopoⅡα的表达指标不能预测口腔鳞状细胞癌的化疗效果和预后。

Objectives To study the clinical significance of expression of glutathion stransferases-π （GST-π） and topoisomerase Ⅱ α （Topo Ⅱα） between two parts of the resected samples of oral squamous cell carcinoma. Methods 39 samples of oral squamous cell carcinoma, including 20 cases without chemotherapy and 19 cases received chemotherapy, were detected the expression of GST-π and Topo Ⅱ α in surface layer and deep invasive areas by immunohistology. Results In the surface layer areas of 20 samples above, the expressions of GST-π and Topo Ⅱ α were 18（90%） and 15（75%）, with 15 and 1 of the deep invasive areas respectively. Opposite to the chemotherapy group, those were 16 and 18, 12 and 8 respectively. GST-π and Topo Ⅱ α expressions were significant differences between surface layer and deep invasive areas （P〈0.05）. GST-π expression was only in deep invasive areas, Topo Ⅱ α expression was significant difference between surface layer and deep invasive areas （P〈0.05）. The results showed no relation to sex, age, histologic grading, clinical substage, tumor site, 3-year disease-free survival of patients and the effect of chemtherapy. Conclusions Drug resistance gene and its associated proteins exist the heterogeneity in squamous cell carcinoma. Drug resistance gene may be changed by chemotherapy, and it maybe help for choosing inducing and assistant chemotherapy. The expressions of GST-π and Topo Ⅱ α can not reflect chemotherapy effect and prognosis of squamous cell carcinoma.