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題名 | Expression of DNA Topoisomerase Ⅱα and Multidrug Resistance p-Glycoprotein in Acute Leukemia=急性白血病細胞中DNA Topoisomerase Ⅱα及多重抗藥性p-醣蛋白之表現 |
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作者 | 邱昌芳; 周寬基; 林芳民; 林從慶; 劉顯敏; 陳光耀; | 書刊名 | 中華醫學雜誌 |
卷期 | 60:4 1997.10[民86.10] |
頁次 | 頁184-190 |
分類號 | 415.635 |
關鍵詞 | 急性白血病; 多重抗藥性; Acute leukemia; DNA topoisomerase Ⅱα; MDR1; |
語文 | 英文(English) |
中文摘要 | 背景:癌細胞對化學治療藥物之抗藥性是造成急性白血病治療失敗的一個主要原因,多重抗藥性(MDR1)基因和topoisomerase IIα (topo IIα)基因都是與抗藥性有關之基因。多重抗藥性(MDR1)基因的過度表現及topo IIα活性降低已知是造成癌細胞對化學治療藥物之抗藥性的兩個重要機轉;本文即是在探討這兩個基因之表現在急性白血病之臨床意義。 方法:在68個急性白血病病人的骨髓切片標本中,我們以免疫組織化學染色法檢查其 topo IIα蛋白及MDR1基因產物gp-170的表現。並依據其表現之強弱將病人分X為4組:(1)高topo IIα和gp-170陰性者;(2)高topo IIα和gp-170陽性者;(3)低topo II α和gp-170陰性者;(4)低topo IIα和gp-170陽性者。臨床病人之反應乃依據一般之追蹤,其與該二種基因表現之相關性則是以Analysis of variance 及Pearson Chi-square test等統計方法來檢驗。 結果:當分別單獨檢驗topo IIα或gp-170之表現與臨床治療之反應以及最終存活率之關係時,兩者均無有意義之差異。但將兩者合併分析如上述之分類時,其第一組(高tpo IIα及gp-170 陰性者)病人之完全緩解率(50%)則遠高於其他三組;同時第一組病人也有較長之存活期。 結論:在急性白血病初期診斷時,單獨分析topo IIα或gp-170之表現,並不能提供有意義之預後參考;若同時檢查topo IIα和 gp-170時,則可以提供預測臨床治療反應與預後一個有用的指標。 |
英文摘要 | Background: Drug resistance is a major cause of treatment failure in acute leukemia. Overexpression of multidrug resistance gene and decreased activity of topoisomerase IIα are suggested as two important mechanisms for this resistance. Methods: We used immunohistochemical method to determine the expressions of both topoisomerase IIα (topo IIα) and p-glycoprotein (gp-170) in bone marrow biopsy specimens from 68 cases of acute leukemia. Patients were divided into four groups: (1) leukemia cells with high score for topo IIα and negative for gp-170; (2) leukemia cells with high score for topo IIα and positive for gp-170;(3) leukemia cells with low score for topo IIα and negative for gp-170; and (4) leukemia cells with low score for topo IIα and positive for gp-170. The clinical responses were then followed as routine, and the clinical correlationwas evaluated by analysis of variance and Pearson Chi-Square test. Results: The measure of the single parameter (either topo IIα or gp-170 alone) did not show a significant difference in the overall survival. However, the complete response rate was much higher in the first group patients whose bone marrow reading score was high in topo IIα and negative for gp-170 expression. Survival duration increased with the increase in the complete response rate. Conclusions: Combined parameters of topo IIα and gp-170 are more useful than any individual parameter for the prognosis of acute leukemia. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。