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目的:探讨MGMT甲基化如何影响替莫唑胺对胶质母细胞瘤的治疗效果。方法:选取41个胶质母细胞瘤患者(根据相同替莫唑胺化疗方案治疗下临床结局的不同分为两组)的肿瘤组织,采用甲基化特异性聚合酶链反应分析胶质瘤组织中MGMT基因启动子区过甲基化状态,同时采用免疫组织化学法分析胶质瘤组织中MGMT蛋白表达情况。结果:临床结局不佳组中,以MGMT蛋白表达阳性的肿瘤为主(72.2%),而在结局相对良好组中,MGMT蛋白表达的阳性率仅为39.1%;在MGMT蛋白表达阳性的22例胶质母细胞瘤组织中,7例MGMT启动子甲基化,阳性率为31.8%,在MGMGT蛋白表达阴性的19例中,14例MGMT启动子甲基化,阳性率为73.7%(P<0.05)。结论:MGMT基因启动子区的甲基化状态与MGMT蛋白的表达相关。MGMT基因启动子过甲基化,MGMT蛋白表达较低;MGMT基因启动子去甲基化,MGMT蛋白表达较高。MGMT启动子过甲基化通过抑制MGMT基因的表达而增加替莫唑胺的疗效。
Objective: To investigate how MGMT methylation affects the therapeutic effect of temozolomide on glioblastoma. Methods: Forty-one patients with glioblastoma (divided into two groups according to the same clinical outcome of temozolomide chemotherapy) were enrolled in this study. Methylation-specific polymerase chain reaction (PCR) was used to analyze the expression of MGMT in glioma tissues Promoter region over-methylation status, while using immunohistochemical analysis of glioma tissue MGMT protein expression. Results: In the poor clinical outcome group, the majority of MGMT positive tumors were found (72.2%), while the positive rates of MGMT protein expression were only 39.1% in the relatively poor outcome group. Among the 22 MGMT positive cases Among the glioblastoma tissues, methylation of 7 MGMT promoters was found in 31 cases of MGMT promoter methylation, of which MGMT promoter methylation was found in 14 MGMT negative cases (73.7%) (P < 0.05). Conclusion: The methylation status of MGMT gene promoter is related to the expression of MGMT protein. MGMT gene promoter hypermethylation, MGMT protein expression is low; MGMT gene promoter demethylation, MGMT protein expression higher. MGMT promoter hypermethylation increases the efficacy of temozolomide by inhibiting the expression of the MGMT gene.