P-gp170、GST-π、TOPOⅡ在外周T细胞淋巴瘤中的表达及意义

Significance of P-glucoprotein,glutathione S-transferase π ,topoisomerase Ⅱ,expression in nodal peripheral T-cell lymphama

目的:探讨多药耐药(MDR)相关的P糖蛋白(P-gp170)、谷胱甘肽-S-转移酶(GST-π)、拓扑异构酶(TOPOⅡ)在不同亚型外周T细胞淋巴瘤(PTCL)的表达情况以及和化疗反应性、预后的关系。方法:应用免疫组化方法检测64例经病理确诊的PTCL患者病理组织P-gp170、GST-π、TOPOⅡ的表达情况,并分析它们之间的相关性以及与病理亚型、化疗效果、预后的关系。结果:64例患者中PTCLP-gp170、GST-π、TO-POⅡ表达阳性率分别为57.8%(37/64)、51.6%(33/64)和53.1%(34/64)。三者的表达无显著的相关性(P>0.05)。P-gp170在PTCL-U和ALK+ALCL两组中的表达具有显著性差异(P=0.0182)。P-gp170表达强阳性和首程化疗后完全缓解(CR)、部分缓解(RR),均呈显著负相关(P=0.000)。本文综合定义的MDR高危组(≥2分)和RR具有显著负相关(P=0.002)。P-gp170表达强阳性和MDR高危组和预后相关(P=0.000;P=0.0145)。PTCL的病理亚型、对化疗的反应性(包括CR和RR)为外周T细胞淋巴瘤的独立预后因素。P-gp170糖蛋白、GST-π、TOPOⅡ尚不能作为独立预后因素。结论:P-gp170糖蛋白、GST-π、TOPOⅡ的表达在PTCL的不同亚型中有一定的差异,在一定程度上和PTCL的耐药性以及不良预后有关。

Objective： To study the expressions of P - gp170, GST -π, TOPO Ⅱ in peripheral T - cell lymphomas （PTCL） , and investigate the correlation of with chemotherapy response and prognosis of PTCL. Methods：Sixty four patients with PTCL were detected for the expressions of P - gp170,GST - π,TOPO Ⅱ by immunohistochemistry method. Results：57.8% （37/64） ,51.6% （33/64） and 53.1% （34/64） patients were positive for P - gp170,GST -π and TOPO Ⅱ expression respectively （ P 〉 0.05 ）. Exprssion of P - gp170 was significant difference between PTCL - U and ALK ＋ ALCL（P =0.0182）. Synthetic definited MDR high risk group （≥2 point） was inverse correlated to partial remission（P = 0.002）. Overall survival rate of P- gp170 strong positive and Synthetic definited MDR high risk group were significantly lower than those of negative patients （P = 0.000, P = 0.0145 ）. P- gp170, GST- π and TO- POlI were not independent prognostic factors. Conclusion：Expression of P- gp170, GST-π,TOPO Ⅱ were different in PTCL＇s pathology subgroups, and related to multidrug resistance and poor prognosis of PTCLs.