P53表达对胶质母细胞瘤替莫唑胺疗效的影响

Impact of P53 status to response of temozolomide for multiform glioblustomas

目的探讨突变型P53表达情况对胶质母细胞瘤替莫唑胺（蒂清胶囊）化疗临床预后的影响。方法入选经手术、放疗和替莫唑胺联合治疗的伴O^6-甲基鸟嘌呤-DNA转移酶（MGMT）低表达的胶质母细胞瘤患者，利用生存分析比较突变型P53高表达组患者与低表达组患者的临床预后是否存在统计学差异。结果患者性别、年龄、Kamofsky生活状态（KPS）评分及肿瘤切除程度在两组患者间无统计学意义，突变型P53低表达组患者的肿瘤无进展生存时间明显长于高表达组（P〈0．05），两组患者的生存时间无统计学意义。结论P53可能参与多形性胶质母细胞瘤替莫唑胺化疗的耐药机制，是影响其临床预后的一种生物指标。

Objective This study was designed to assess the clinical outcomes of MGMT low expression glioblastomas with different expression level of mutant P53 to the response of temozolomide chemotherapy. Method Glioblastomas with low MGMT expression were treated with surgical resection, radiotherapy and temozolomide capsule chemotherapy. They were divided into high and low mutant P53 expression groups. Patient age, gender, KPS score and extent of resection were anyalzed between the two groups. Correlation between P53 status and control of tumor growth were analyzed by survival analysis. Results No statistically significant difference in age, gender, KPS score or extent of resection existed between the two groups. Patients with both low mutant P53 expression and low MGMT had much longer progression-free survival time to temozolomide capsule than those with high mutant P53 expression and low MGMT （P 〈 0.05 ）. Overall survival time did not reach statistical significance between the two groups. Conclusions P53 plays a role in chemotherapy resistance to temozolomide. Glioblastoma patients with both low MGMT and low mutant P53 expression have higher progression-free survival time and may have longer term prognosis.