膀胱癌P糖蛋白、谷胱甘肽S转移酶-π、DNA拓扑异构酶Ⅱ-α表达及其意义

Expression of P-glycoprotein, Glutathoine-S-Transferase π and DNA topoisomeraseⅡ-α in primary transitional cell carcinomas of bladder

目的 :探讨膀胱癌中 P糖蛋白 (Pgp)、谷胱甘肽 - S-转移酶 -π(GST-π)、DNA拓扑异构酶 -α(Topo -α)表达情况及其临床意义。方法 :采用免疫组织化学 SP法 ,检测 10 7例原发性膀胱移行细胞癌中 Pgp、GST-π、Topo - α的表达情况。结果 :Pgp、GST- π总阳性表达率分别为 6 3.6 %、72 .9% ,二者的表达与该肿瘤的病理分级、临床分期和术后腔内化疗的复发密切相关。所有膀胱癌细胞均有不同程度的 Topo - α表达降低 ,其中 Topo - α指数 、 、 、 级分别为 45 .0 %、36 .3%、12 .5 %、6 .3% ,Topo - α指数与病理分级有关、但与临床分期和术后腔内化疗的复发无关。 Pgp与 GST- π、GST- π与 Topo - α指数密切相关 ,Topo - α指数与 Pgp表达无关联。结论 :Pgp、GST-π表达情况和 Topo -α指数是判定原发性膀胱移行细胞癌恶性程度的客观指标 ;在预测以塞替派和丝裂霉素为主的术后腔内化疗敏感性方面 ,Pgp、GST-π表达情况较 Topo -α指数更为有效。

Purpose:To investigate the expressions of P glycoprotein(Pgp), Glutathoine S Transferaseπ (GST π) and DNA topoisomeraseⅡ α (TopoⅡ α) in human primary bladder transitional cell carcinomas (TCCs) and their clinical significance.Method:107 primary bladder TCCs were analyzed preoperatively for expression of Pgp, GST π and TopoⅡ α by means of SP immunohischemistry (IHC).Results:The expressions of Pgp, and GST π were present in 63.6 % and 72.9 % of all TCCs respectively. The expressions of Pgp and GST π were significantly correlated with the grade, stage and recurrence after post operative intravesical chemotherapy. The expressions of TopoⅡ α in all cases were reduced in different degrees. TopoⅡ α index Ⅰ,Ⅱ,Ⅲ and Ⅳ were 45.0 %? 36.3 %? 12.5 %? 6.3 %, respectively. TopoⅡ α index were related to grade but not stage and recurrence after post operative intravesical chemotherapy. The significant relationships between Pgp and GST π, GST π and TopoⅡ α indexs were found, but TopoⅡ α indexs were not related to the expression of Pgp.Conclusions:Expression of Pgp, GST π and TopoⅡ α index can be used as the important markers of the aggressiveness of TCCs.Expression of Pgp, GST π are more efficacious than TopoⅡ α index to predict the sensitivity to intravesical chemotherapy with thiotepa or MMC.