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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 investigate the expression and clinical significance of glutathione S transferase π (GSTπ), DNA topoisomerase IIα (TopoIIα) and P-glycoprotein (p170) in patients with acute leukemia (AL). Methods Immunohistochemical SP method was used to detect the expression of GSTπ, TopoIIα and p170 in leukemia cells from 94 AL patients. Results The positive rates of GSTπ, TopoIIα, and p170 in the untreated group (group A) and relapsed or refractory group (group B) in ANLL were 20%, 43%, 20%, and 500%, respectively. %, 500%, 467%; the positive rate of the three in ALLA group and B group were 4 3%, 0, 18 2% and 30%, 18 2%, 30%, respectively. The complete remission rate (CR) and GSTπ-negative, TopoIIα-positive, and p170-negative CR rates of GSTл-positive, TopoIIα-negative, and p170-positive AL patients were 250%, 75.0 %, 38.5 %, 81 8%, 37 5 %, respectively. 84 2%. In addition to TopoIIα, the CR rate was lower in patients with positive drug resistance than in negative patients (P <0 01 and 0 05). Correlation analysis showed a close positive correlation between GSTπ and p170 (r = 0.64, P < 0 01). Conclusion The overexpression of GSTπ and p170 is closely related to the efficacy and prognosis of chemotherapy in AL patients, and there is a positive correlation between GSTπ and p170 overexpression.