MGMT在人脑胶质瘤中的表达及其临床意义

Expression of Drug Fast Enzyme MGMT in Human Brain Gliomas and Its Clinical Significance

目的探讨耐药酶O6甲基鸟嘌呤-DNA-甲基转移酶(MGMT)在人脑胶质瘤中的表达及其临床意义。方法通过免疫组织化学方法检测60例脑胶质瘤患者MGMT蛋白表达情况,分析其与WHO分级的关系;同时对MG-MT表达为阳性的40例患者,分别采用化疗药物TMZ和CCNU进行化疗,观察比较两组的有效率、控制率。结果根据WHO分级,MGMT蛋白在Ⅰ～Ⅳ的阳性表达率分别为37.5%、66.7%、78.6%和100.0%。经χ2趋势检验,各等级之间差异有统计学意义(P<0.05)。通过强化CT或增强MRI判断病灶变化情况,TMZ组有效率(CR+PR)为22.7%,CC-NU组有效率为5.6%,两组差异有统计学意义(P<0.05)。TMZ组控制率(CR+PR+MR)为59.1%,CCNU组控制率为16.7%,两组差异有统计学意义(P<0.05)。结论MGMT表达对判定肿瘤的恶性程度对于制定化疗方案有重要参考价值,TMZ较CCNU更适用于MGMT表达阳性恶性脑胶质瘤的治疗。

Objective To investigate the expression of drug fast enzyme MGMT in human brain gliomas and its clinical chemotherapy value. Methods MGMT expression in 60 glioma specimens was examined by immunohistochemistry method, then the association of MGMT expression and WHO classification was analyzed. Meanwhile, 40 patients with MGMT positive expression were divided into two groups and given TMZ and OCNU respectively, the effective rate and the control rate were observed. Results According to WHO classification, MGMT positive expression in grade Ⅰ～Ⅳ were 37.5 %, 66.7%, 78.6%, and 100.0 %, respectively. Using Xz trend test, there was a statistically significant difference among each grade （P 〈 0.05）. After contrast- enhanced CT or GD- MRI examination, the response rate was 22.7 % in TMZ group, and .5.6 % in CCNU group; the two groups had statistically significant differences （P〈 0.05）. The control rate was 59.1% in TMZ group and 16.7 % in CCNU group, there were statistically significant differences between the two groups （P〈 0.0.5）. Conclusions It is significant to detect MGMT expression simultaneously when judging the malignant degree of glioma and selecting chemotherapeutic plan for an individual patient. Comparing with CCNU, TMZ is more suitable for patients with MGMT positive expression.