Volm M, Zintl F, Edler L, Sauerbrey A
Department of Oncological Diagnostics and Therapy, German Cancer Research Center, Heidelberg, Germany.
Med Pediatr Oncol. 1997 Feb;28(2):117-26. doi: 10.1002/(sici)1096-911x(199702)28:2<117::aid-mpo5>3.0.co;2-n.
In this investigation, untreated non-B-type acute lymphoblastic leukemia (ALL) of 104 children was analyzed using immunocytochemistry for expression of protein kinase C, proto-oncogene products (Fos, Jun, Ras) and resistance-related proteins (topoisomerase II, P-glycoprotein, glutathione S-transferase-pi, metallothionein, dihydrofolate-reductase, thymidylate-synthase). The aim of the analysis was to find out whether combining those factors with the most important clinical prognostic factor (blast cell count) can improve the prognostic value (relapse-free interval). Univariate analysis shows that protein kinase D (PKC), Fos, P-glycoprotein (P-170) and glutathione S-transferase-pi (GST-pi) are significant prognostic factors independent of blast cell count (PBC) for the relapse-free intervals of children with ALL. The presence of the proteins Fos, PKC, P-170 and GST-pi was not independent within the patient population. The multivariate analysis showed that in combination with PBC and PKC, both P-170 and GST-pi have only limited prognostic influence. Combining the factors PKC, Fos and GST-pi as a categorical variable showed that this variable is a strong prognostic factor in addition to PBC.
在本研究中，采用免疫细胞化学方法分析了104例儿童未经治疗的非B型急性淋巴细胞白血病（ALL）中蛋白激酶C、原癌基因产物（Fos、Jun、Ras）和耐药相关蛋白（拓扑异构酶II、P-糖蛋白、谷胱甘肽S-转移酶-pi、金属硫蛋白、二氢叶酸还原酶、胸苷酸合成酶）的表达情况。分析目的是确定将这些因素与最重要的临床预后因素（原始细胞计数）相结合是否能提高预后价值（无复发生存期）。单因素分析显示，蛋白激酶D（PKC）、Fos、P-糖蛋白（P-170）和谷胱甘肽S-转移酶-pi（GST-pi）是ALL患儿无复发生存期独立于原始细胞计数（PBC）的显著预后因素。在患者群体中，Fos、PKC、P-170和GST-pi蛋白的存在并非相互独立。多因素分析表明，与PBC和PKC相结合时，P-170和GST-pi的预后影响均有限。将PKC、Fos和GST-pi作为分类变量进行组合分析显示，该变量除PBC外是一个强有力的预后因素。
