经典P-gp在儿童淋巴瘤和肾母细胞瘤中的表达及意义

Expression and significance of P-gp in childhood lymphoma and Wilms

摘要:

【摘要】目的：探讨P-糖蛋白（P-glycoprotein，P-gp）在儿童霍奇金淋巴瘤(Hodgkin disease，HL)、非霍奇金淋巴瘤(Nonhodgkin lymphoma，NHL)和肾母细胞瘤（Nephroblastoma，WT）中的表达意义，为临床制定个体化疗方案提供理论依据。方法 采用免疫组织化学SP法检测 50 例淋巴瘤（HL 26 例、NHL 24 例）和 32 例肾母细胞瘤中 P-gp 的表达情况，及其与临床病理特征的关系。结果 （ 1 ）P-gp 在 HL、NHL、WT 中的阳性表达率分别为 57.7%、70.8%、65.6%。（2）HL和 NHL 中 P-gp 的表达差异无统计学意义（P=0.39）， WT 与癌旁对照组中 P-gp 的表达差异无统计学意义( P=1.00 )。（3）HL的乳酸脱氢酶（LDH）的量、有无纵隔病变对 P-gp 表达的影响有显著性意义（P=0.03、P=0.05）；NHL 的临床分期对 P-gp 的表达影响也有显著性意义(P=0.02)；肾母细胞瘤的组织分型、临床分期、有无淋巴结转移和术前化疗对 P-gp 的表达无显著性差异（P=0.53、P=0.25、P=0.64、P=0.45）。结论 （1）P-gp的高表达与儿童 HL、 NHL 和 WT 的耐药密切相关，是这三种肿瘤预后的不利因素。（2）在临床上我们可以根据肿瘤耐药蛋白的表达情况而针对性的选择化疗药物，使肿瘤患儿用上敏感的化疗药物。

Abstract:

【Abstract】Objective: This study aimed to detect the expression of P-gp in pediatric hodgkin lymphoma,nonhodgkin lymphoma and Nephroblastoma,which can provide a theoretical basis for individual chemotherapy in clinical. Methods:Immunohistochemistry was performed to detect the expression of P-gp in pediatric tumors(26HL,24NHL and 32WT), and we can evaluated the relationship between P-gp and the clinical characteristics of tumors. Results: (1)The positive expression rates of P-gp was 57.7%,70.8%,65.6% in HL, NHL and WT.(2)There was no significant difference among HL and NHL(P=0.39),WT and adjacent normal tissues(( P=1.00) about the positive expression rates of P-gp.(3) The positive expression rates of P-gp was closely related to clinical stage, LDH, lymphnode metastasis in HL(P=0.03, P=0.05), and was related to the clinical stages in NHL(P=0.02). There was no significant correlation between the espression of P-gp with histological type, clinical stage, lymphnode metastasis, and preoperative chemotherapy time. Conclusion: (1)The high positive expression of P-gp correlate with tumor resistant of HL, NHL and WT, and there is one of unfavorable factors in prognosis.(2) According to resistance protein expression,we can better choice chemotherapy drugs in clinical, in orde to the tumor children use sensitive durg.