摘要
目的:通过观察神经胶质瘤中O6甲基鸟嘌呤DNA甲基转移酶(O6methylguanineDNAmethyltransferaseMGMT)的表达状态,探讨MGMT在胶质瘤中的表达与亚硝脲(ACNU/BCNU)耐药之间的关系;同时对于部分MGMT阳性患者给予链脲菌素(STZ)联合ACNU/BCNU治疗,观察疗效。方法:采用免疫组化法对神经胶质瘤石蜡标本检测MGMT,并与临床亚硝脲的随访结果进行比较;对8例MGMT阳性率高且对亚硝脲治疗无效的难治性脑瘤患者,开展STZ联合ACNU治疗。结果:68例神经胶质瘤,MGMT表达的总阳性率为55.9%。在使用亚硝脲治疗的患者中,除8例加用STZ联合治疗外,余60例中,27例MGMT(-)者,使用ACNU治疗绝大部分有效;30例MGMT(+～++)者,使用ACNU治疗后绝大部分复发或死亡,表明MGMT表达与亚硝脲化疗呈负相关;另外8例MGMT阳性患者在进行了STZ联合ACNU治疗后,1例可测肿瘤全部消失,2例肿瘤体积缩小在50%以上,4例肿瘤体积消退<50%,1例无效。结论:MGMT阳性的胶质瘤患者比MGMT阴性的患者明显耐药,且耐药程度与MGMT表达强度无关,仅与其是否阳性有关。对于MGMT阳性患者,可选择ACNU/BCNU联合STZ使用,以提高亚硝脲的疗效。因此,化疗前检测胶质瘤MGMT的表达情况,预测化疗敏感性,对指导临床化疗具有重要意义。
Objective ：To examine the expression of O^6-methylguanine-DNA methyhransferase（MGMT） in human gliomas and to investigate MGMT expression association with nitrosourea resistance and therapeutic evaluation of streptozotocin-A （STZ） and ACNU combination chemotherapy. Methods：68 cases human brain gliomas were detected for MGMT with immunohistochemical staining and compared the results with nitrosourea chemotherapy. 8 cases of patients were received therapy of STZ and ACNU combination chemotherapy. Results：The positive expression rate of MGMT in gliomas was 55.9%. MGMT expression was inversely correlated with nitrosourea chemotherapy in gliomas. Of positive 8 patients that received the therapy of STZ and ACNU combination chemotherapy, except for one patients, they have required activity effect. Conclusion： MGMT expression was correlative significantly with nitrosourea resistance. Patient of MGMT positive could select the therapy of STZ and ACNU combination chemotherapy. So it is important to detect MGMT before using nitrosourea chemotherapy.
出处
《临床肿瘤学杂志》
CAS
2006年第1期19-22,共4页
Chinese Clinical Oncology
