| Objective: To explore the correlations of lung resistance protein(LRP) and glutathione S transferase π(GST-π) to chemotherapy resistance and prognosis of epithelial ovarian cancer. The significance is to find ovarian cancer tumor marker from biological standpoint, as a screening of chemotherapy drugs. The expression of LRP and GST-π can be used to predict chemotherapy resistance and prognosis of ovarian cancer, it is important to elucidate on the mechanism of platinum-resistant ovarian cancer and improve chemotherapy efficacy in ovarian cancer.Methods:1 The object of studyThis study adopted the method of retrospective study, 66 patients with epithelial ovarian cancer were selected in gynecological department at the fourth hospital of Hebei province between January 2007 to January 2010, including 41 serous carcinoma(62.1%), 20 mucinous carcinoma(30.3%), 3 endometrial carcinoma(4.5%), 2 clear cell carcinoma(3%). The age range of the patients was 25 to 74 years old, with a median age is 54 years old. According to the 2000 FIGO staging criteria: early(Ic ~ IIc), 20 cases(30.3%), late(III ~ IV), 46 cases. All patients had complete clinical data, including the data of operation and chemotherapy, and not received preoperative radiotherapy, chemotherapy and immune therapy. All patients were pathologically diagnosed with ovarian cancer after operation, they received postoperative platinum chemotherapy of 6-8 courses, except for patients who did not receive platinum-based chemotherapy less than 3 courses or suffer from other diseases that affected the survival. According with the chemotherapy efficacy criteria, the patients divided into sensitive group and resistant group.2 To study clinical and pathological data of 66 cases, immunohistochemical staining method was used to measure protein expression of LRP and GST-π in epithelial ovarian cancer and analyze the correlations of LRP and GST-π to chemotherapy resistance and the prognosis of ovarian cancer.3 Statistical analysis: Statistical analysis was performed using the SPSS 13.0 software package. Enumeration data were compared with χ2 test, the association between expression of LRP and GST-π was performed with Spearman correlation analysis. Survival analysis was performed using the Kaplan–Meier method, p-value below 5% was considered as significant.Results:1 Overall survival of study:The follow-up rate of 66 cases was 100%. After surgery, 1-year, 3-year and 5-year overall survival rates were 97.0%, 69.7%, 50.0%, 33 cases were dead, accounting for 50.0%, all the deaths are caused by recurrence or metastasis of ovarian cancer.2 The association between clinical characteristics of ovarian cancer patients and the expression of LRP and GST-π:Statistical analysis showed that the expression of LRP and GST-π was not significantly associated with age, clinical stage, histological type, pathologic grade, surgery residual size of the patients.(P>0.05).3 The association between the expression of LRP, GST-π and the chemotherapy efficacy in ovarian cancer:In 66 ovarian cancer tissues, LRP was positive in 49 cases, 30 cases of short-term chemotherapy was effective, the chemotherapy efficacy was 61.2%, LRP was negative in 17 cases, 16 cases of short-term chemotherapy was effective, the chemotherapy efficacy was 94.1%, there was significant difference compared between the two groups(P=0.011). GST-π was positive in 47 cases, 29 cases of short-term chemotherapy was effective, the chemotherapy efficacy was 61.7%, GST-π was negative in 19 cases, 17 cases of short-term chemotherapy was effective, the chemotherapy efficacy was 89.5%, there was significant difference compared between the two groups(P=0.026).4 The association between the expression of LRP, GST-π and chemotherapy resistance in ovarian cancer:In chemotherapy-resistant group, 21 cases were LRP positive, 2 cases were negative, the positive rate of LRP expression was 91.3%, in sensitive group, 28 cases were LRP positive, 15 cases were negative, the positive rate of LRP expression was 65.1%, there was significant difference compared between the two groups(P=0.020). In chemotherapy-resistance group, 20 cases were GST-π positive, 3 cases were negative, the positive rate of GST-π expression was 87.0%, in sensitive group, 27 cases were GST-π positive, 16 cases were negative, the positive rate of GST-π expression was 62.8%, there was significant difference compared between the two groups(P=0.039).5 The correlation between expression of LRP and GST-π in epithelial ovarian cancer:The expression of LRP and GST-π were both positive in 39 cases and both negative in 9 cases. Spearman correlation analysis showed that there was the correlation between the expression of LRP and GST-π in epithelial ovarian cancer tissues(r=0.314, P=0.010).6 The association between the expression of LRP, GST-π and the survival time of patients after operation:Log-rank test showed, median survival time of LRP negative was 74 months, median survival time of LRP positive was 54 months, median survival time of GST-π negative was 66 months, median survival time of GST-π positive was 49 months, survival time of LRP, GST-π positive were both lower than survival time of LRP, GST-π negative patients. median survival time of LRP and GST-π both negative was 78 months, both positive median survival time was 49 months. In comparison, the difference was statistically significant(P<0.05).Conclusions:1 There is significantly association between the expression of LRP, GST-π and the chemotherapy efficacy in ovarian cancer. In LRP and GST-π positive cases, chemotherapy efficiency has significantly reduced. There is significantly association between LRP and GST-π expression and chemotherapy resistance in epithelial ovarian cancer, with high expression in the resistant group. Moreover, there was significantly correlation between the positive expression of LRP and the positive expression of GST-π in epithelial ovarian cancer, both of them can be combined to predict early resistance.2 The expression of LRP and GST-π in epithelial ovarian cancer may predict prognosis of patients, the patients with positive expression of LRP and GST-π have poor prognosis. |
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