Multidrug resistance is a major obstacle in paediatric cancer
Chemotherapy.P- glycoprotein is a transmembrane product of mdri gene that
Acts as an efflux pump mechanism draining drugs out of the cells. Widely
Disseminated neuroblastoma in children remains a disease of poor prognosis
With high incidence of intrinsic and aquired drug resistance. The role of pglycoprotein
And its prognostic value in neuroblstoma was investigated in a total
Number of 32 cases, receiving either cyclofosfamide (ctx), platinol
(cddp), vepesid (vp16), and adriamycin (adr) or vincristine (vcr),
(adr), actinomyein-d (amd) and ctx. The mean age was 4.7 years and
The male to female ratio was 1.The cases included 17 surgical specimens and
15 biopsies. Tumour grading was done according to shimada classification.
Lmmunoperoxidase studies for p-glycopmtein were performed on formalin-
Fixed, paraffin embedded sections using the isb-1 mouse monoclonal antibody,
And light green as a counter stain.Cases were scored according to the
Percent number of positive cells:strongly positive when more than 50% of
Cells were stained,thildly positive when 11-50% were stained and negative
When 0-10% of cells were stained.A high percentage reactivity for pglycoprotein
Was detected in75% of cases, of which 58.3% were males. Positivity
Was more in the unfavourable group according to the shimada classification
(66.6%) and more with advanced stages 111 and iv (87.5%).A high
Percentage of 83.3% of the p-glycoprotein positive cases died within the first
Year of treatment. Conclusion: late clinical stages and unfavourable histology
Correlate with high p-glyc.Protein expression and hence poor prognosis in
Neuroblastoma
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