经典P-糖蛋白在儿童淋巴瘤和肾母细胞瘤中的表达及意义

Expressions and significances of P-glycoprotein in childhood lymphoma and Wilms’ tumor

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（non-Hodgkin disease，NHL）和肾母细胞瘤（Wilms’ tumor，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ＷＴ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的乳酸脱氢酶的量、有无纵膈病变对P-gp表达的影响有统计学意义（P=0.03、P=0.05）；NHL 的临床分期对 P-gp 的表达影响也有统计学意义（P=0.02）；ＷＴ的组织分型、临床分期、有无淋巴结转移和术前化疗对 P-gp 的表达差异无统计学意义（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３种肿瘤预后的不利因素。（2）在临床上可以根据肿瘤耐药蛋白的表达情况针对性地选择化疗药物，使肿瘤患儿用上敏感的化疗药物。

Abstract:

Objective：To detect the expressions of P-glycoprotein（P-gp） in pediatric Hodgkin disease（HL），non-Hodgkin disease（NHL） and Wilms’ tumor（WT） and to provide theoretical basis for individual chemotherapy in clinics. Methods：Immunohistochem－istry was performed to detect the expressions of P-gp in pediatric tumors（26 cases of HL，24 cases of NHL and 32 cases of WT） and relationship between expressions of P-gp and clinical characteristics of tumors was evaluated. Results：（1）Positive expression rates of P-gp were 57.7%，70.8%，65.6% in HL，NHL and WT. （2）There was no significant difference in P-gp expressions between HL and NHL（P=0.39），between WT and adjacent normal tissues（P=1.00）. （3）Positive expression of P-gp was closely related with lactate dehydrogenase，lymphnode metastasis in HL（P=0.03，P=0.05） and was related with clinical stages in NHL（P=0.02）. There was no significant correlation between expressions of P-gp and histological type，clinical stage，lymphnode metastasis and preoperative chemotherapy of WT. Conclusions：（1）High positive expression of P-gp correlates with tumor resistant of HL，NHL and WT and is one of the unfavorable factors for prognosis. （2）According to expressions of tumor resistant protein，we can better chose chemotherapy drugs in clinics and make children with tumor use sensitive drug.