Expressions of MDR and GST-? related to the response of neoadjuvant chemotherapy and prognosis in cervical cancer / 中国癌症杂志

ABSTRACT

Purpose:To evaluate the relationship between the expressions of MDR and GST-? and the response to neoadjuvant chemotherapy and prognosis in cervical carcinoma. Methods:The expressions of MDR and GST-? were examined by Envision immunohistochemistry using pretreatment biopsy specimens. The stage distribution of 57 patients in the study was 7 stage Ib, 35 stage IIa, 15 stage IIb. Treatment consisted of 2 courses of neoadjuvant chemotherapy followed by radical hysterectomy and lymphonectomy. If the patient was found to have parametrial involvement, pelvic lymph node metastasis, microscopic tumor emboli or disease in vagina stemp, she was given adjuvant radiotherapy after operation. All patients were followed up and the median follow-up time was 35 months (21-66 months). Statistical method used was SPSS 8.0 package. Results:There were 14 patients with cervical carcinoma who had expression of MDR. The rate of expression of MDR was 24.6% (14/57). Also there were 29 patients who had expression of GST-?. The rate of expression was 50.8% (29/57). The total response rate of neoadjuvant chemotherapy was 81%. The complete clinical response rate was 19% (11/57) and partial response rate was 61% (35/57). All patients were treated by operation following chemotherapy and 13 patients were given adjuvant radiotherapy after operation. The 5-year survival rate in stage Ib was 100%, stage IIa 90% and stage IIb 78.5%. The results showed the expression of MDR was related to response of neoadjuvant chemotherapy and 5-year survival. It is 93%(40/43) in group of MDR(-) and 43%(6/14) in group of MDR(+)( P =0.001). But it was not related to FIGO, histopathologic, parametrial involvement, and pelvic lymph nodes metastasis. The expression with GST-? only related to response of chemotherapy. The response rate in the group with expression of GST-? is 69% and it is 93% in the group with GST-?(-)( P =0.02).Conclusions:The response rate of neoadjuvant chemotherapy in group of MDR(-) and GST-?(-) was better than in the group with expression of MDR and GST-?. The measure of MDR and GST-? is helpful to predict the response of neoadjuvant chemotherapy in cervical cancer and MDR may related to prognosis of cervical cancer.