| BackgroundChoriocarcinoma is a highly malignant tumor which is very common in child-bearing ages of females. Despite of the fact that most patients are sensitive to chemotherapy, the curable rate of choriocarcinoma remains poor when the cancer cells become resistant to chemotherapy. So exploring the mechanisms of chemoresistance of choriocarcinoma is very significant to improve patient’s survival.C1QBP, which is short for Complement component1Q subcomponent binding protein, is a key-point in this study. The former research done by our team showed that there might be a close relation between C1QBP and chemoresistant of choriocarcinoma. The evidence is (1) the expression of C1QBP was higher in the resistant chemo-reagents-induced sub-lines than in the mother cell lines.(2) after the expression of C1QBP is silenced, the IC50and RI of cell lines were decreased significantly; the xenografts in mouse of C1QBP interfered cells showed a retarded growth rate and in VP16injection group, and both of the tumors’volume and weight suppression rate evidently increased. So the first part of this study mainly focuses on the C1QBP level in human peripheral blood and its relation with chemotherapy of choriocarcinoma.One hCG related molecular-hyperglycosylated hCG, has become a hot spot in GTN field. About10years ago scientists in the USA have confirmed that the H-hCG can replace β-hCG as the special tumor marker in GTN. The study about this field is almost blank in China. The second part of this study mainly focuses on this molecule in human peripheral blood and their relations with chemotherapy of choriocarcinoma.Methods1. Objectives:the healthy females, the normal pregnant females and the GTN patients were continuously enrolled in Peking Union Medical College Hospital from Jun2011to Apr2012.2. Collect the specimens and clinical records:all serum specimens were from the remainder of clinical serum (3-hCG assay, which were kept at4℃refrigerator for no more than48hours. Then serum samples were packed in several0.6mL Eppendorfs and transferred to-80℃refrigerator. All the samples were unfrozen only once just before the ELISA assay. The β-hCG levels of the same serum samples and the corresponding clinical data were recorded.3. Detect the serum concentration of C1QBP and H-hCG. The test of C1QBP and H-hCG is done by ELISA kit.4. All the clinical data were analyzed retrospectively. The correlations between C1QBP, H-hCG and the other clinical variables were stratified analyzed.5. SPSS13.0software was utilized for statistical analysis. The W test was adopted to test the normal distribution. The t test was employed to compare the means of two independent-samples with normal distribution. The Mann-Whitney nonparametric test was employed to compare the distrbution of two independent-samples with unknown distribution. The ANOVA nonparametric test was employed to compare the distribution of multiple independent-samples with unknown distribution. LSD-t was employed to do the comparason within groups.Results1.(1) C1QBP can be tested among healthy females and GTN patients, and there’s no significant difference among healthy females(25.16±10.93μg/L) and GTN patients(29.35±9.97μg/L)(P=0.051)(2) C1QBP is much higher in resistant group (38.54±9.17μg/L) than in sensitive group (26.72±8.47μg/L), cured group (25.53±6.49μg/L) and healthy famales (25.16±10.93μg/L)(P=0.000,0.000,0.000), there’s no significant difference among these three groups.(3) C1QBP in the "pre-resistant" serum is much higher than the ones in the "pre-sensitive" serum(P=0.001).(4) C1QBP has nothing to do with the regimens of chemotherapy, neither with the position of resistant nodules(P=0.189,0.294).(5) There’s no significant difference between the one who accepted/hasn’t accepted chemotheropy, before/after chemotherapy and less/more than10days after the chemotherapy (P=0.442,0.421,0.159)(6) In sensitive serum, there’s no difference between the ones which have been resistant to chemotherapy and the one which haven’t been resistant(P=0.967).2.(1) the H-hCG/total hCG level has no significant difference between the females who have been pregnant within8weeks (22.09±20.57%) and more than8weeks (11.86±13.55%)(P=0.317).(2) the H-hCG/total hCG is much higher in sensitive GTN patients (74.6±32.9%) than in normal pregnant females (22.09±20.57%) and resistant patients(12.8±11.1%)(P=0.000,0.000).Conclusion1.(1)There’s no significant difference C1QBP level between healthy females and GTN patients.(2) C1QBP is much higher in resistant patients, which indicated there might be a close relationship between C1QBP and chemoresistant.(3) The increase of C1QBP happens before the chemoresistance, whick means it might induce the chemoresistance. This may lead us to a new way of therapy. And C1QBP has no relation with regimens and position of nodules.(4) C1QBP will not change under the stimulation of chemotherapy, nor as the time past. And it will not keep a persistant high level in chemoresistant serum.2. The rate H-hCG/total hCG is much lower in resistant patients than in sensitive patients. So it might become a new test to monitor the chemoresistance in GTN. |
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