急性白血病患者GSTπ、TopoⅡα和p170表达及临床意义

Clinical significance of glutathione-S-transferase π,topoisomerase Ⅱα and P-glycoprotein expression in acute leukemia

目的 探讨急性白血病 (AL)患者谷胱甘肽 S 转移酶π(GSTπ) ,DNA拓扑异构酶Ⅱα(TopoⅡα)及P糖蛋白(p170 )的表达及临床意义。方法 采用免疫组化S P法检测 94例AL患者白血病细胞中GSTπ、TopoⅡα和p170表达的阳性率。结果 GSTπ、TopoⅡα和 p170在ANLL中的初治组 (A组 )及复发或难治组 (B组 )中的阳性率分别为2 2 0 %、43 2 %、2 2 0 %及 5 0 0 %、5 0 0 %、46 7% ;三者在ALLA组及B组的阳性率分别为 4 3%、0、18 2 %及30 0 %、18 2 %、30 0 %。GSTл阳性、TopoⅡα阴性、p170阳性AL患者完全缓解率 (CR)与GSTπ阴性、TopoⅡα阳性、p170阴性的CR率分别为 2 5 0 %、75 0 %、38 5 %及81 8%、37 5 %、84 2 %。除TopoⅡα外 ,耐药因子阳性患者的CR率低于阴性患者 (P <0 0 1及 0 0 5 )。相关分析显示GSTπ与p170之间密切正相关 (r =0 6 4,P <0 0 1)。结论 GSTπ、p170过度表达与AL患者的化疗疗效及预后密切相关 ,且GSTπ与 p170过度表达密切正相关。

Objective To explore clinical significance of glutathione S transferaseπ(GSTπ), topoisomerase Ⅱα(TopoⅡα) and P glycoprotein (p170) expression in acute leukemia (AL). Methods The expression of GSTπ、TopoⅡα and p170 in 94 patients with AL were determined by monoclonal antibodies using S P method. Results The positive rate of GSTπ, TopoⅡα and p170 expression for untreated, relapse and refractoty acute nonlymophoblastic leukemia cases were 22 0%, 43 2%, 22 0% and 50 0%, 50 0%, 46 7% respectively. The positive rate of GSTπ、 TopoⅡα and p170 expression for untreated, relapse and refractory acute lymphoblastic lcukemia cases were 4 3%, 0, 18 2%,and 30 0%, 18 2%,30 0% respectively. The rates of complete remis sion of patients with AL in GSTπ positive,TopoⅡα negative, p170 positive and GSTπ negative, TopoⅡα positive, p170 negative were 25 0%, 75 0%, 38 5% and 81 8%, 37 5%, 84 2% respeetively. The rate of complete remission were lower in resistence factors positive patents compared with resistance factors negative patients ( P< 0 01 and P< 0 05), except TopoⅡα.There is close positive relationship between GSTπ and p170 ( r= 0 64 P< 0 01 ). Conclusion There is close correlation between overexpression of GSTπ, p170 and response to chemotherapy in patients with AL, and significant correlation between expression of GSTπ and p170.tientswithALinGSTπposit