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目的探讨耐药酶O6甲基鸟嘌呤-DNA-甲基转移酶(MGMT)在人脑胶质瘤中的表达及其临床意义。方法通过免疫组织化学方法检测60例脑胶质瘤患者MGMT蛋白表达情况,分析其与WHO分级的关系;同时对MG-MT表达为阳性的40例患者,分别采用化疗药物TMZ和CCNU进行化疗,观察比较两组的有效率、控制率。结果根据WHO分级,MGMT蛋白在Ⅰ～Ⅳ的阳性表达率分别为37.5%、66.7%、78.6%和100.0%。经χ2趋势检验,各等级之间差异有统计学意义(P<0.05)。通过强化CT或增强MRI判断病灶变化情况,TMZ组有效率(CR+PR)为22.7%,CC-NU组有效率为5.6%,两组差异有统计学意义(P<0.05)。TMZ组控制率(CR+PR+MR)为59.1%,CCNU组控制率为16.7%,两组差异有统计学意义(P<0.05)。结论MGMT表达对判定肿瘤的恶性程度对于制定化疗方案有重要参考价值,TMZ较CCNU更适用于MGMT表达阳性恶性脑胶质瘤的治疗。
Objective To investigate the expression and clinical significance of the drug resistance enzyme O6-methylguanine-DNA-methyltransferase (MGMT) in human glioma. Methods Immunohistochemistry was used to detect the expression of MGMT protein in 60 cases of glioma patients and to analyze its relationship with WHO classification. Meanwhile, 40 patients with positive MG-MT expression were treated with chemotherapeutic drugs TMZ and CCNU respectively, Observed and compared the two groups of efficiency, control rate. Results According to WHO classification, the positive rates of MGMT protein in Ⅰ ~ Ⅳ were 37.5%, 66.7%, 78.6% and 100.0%, respectively. The χ2 trend test, the differences between the grades were statistically significant (P <0.05). In the TMZ group, the effective rate (CR + PR) was 22.7% and the effective rate in the CC-NU group was 5.6%. The difference between the two groups was statistically significant (P <0.05). The control rate (CR + PR + MR) in TMZ group was 59.1%, and the control rate in CCNU group was 16.7%. The difference between the two groups was statistically significant (P <0.05). Conclusion The expression of MGMT has important reference value for the determination of malignancy of tumor, and TMZ is more suitable for the treatment of MGMT positive malignant glioma than CCNU.