Original Contribution EXPRESSION OF GST-PI AND ITS IMPACT ON THE SURVIVAL OF COLORECTAL CANCER PATIENTS UNDERGOING CHEMOTHERAPY

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Resistance to chemotherapeutic agents is a problem facing the oncologist. The glutathione-S-transferase (GST) enzyme system has been implicated in the development of resistance to several anticancer drugs. Our present study is aimed at evaluating the expression of GST-pi in colorectal carcinoma and to determine its impact on the survival of patients treated with particular chemotherapy for colorectal cancer. Immunohistochemistry for GST-pi was performed on 67 biopsies obtained from patients with colon and rectal cancers. Seventeen of the biopsies (25%) appeared to have strong immunohistochemical signal for GST-pi, whereas the remaining 50 were negative (6, 9%) or with weak staining properties (44, 66%). Patients with strong GST-pi immune disposition appeared to have shorter survival after surgery compared to those negative for or with weak GST-pi staining (p=0.005, Log-rang test). Thirty (45%) of the patients received adjuvant mono- or polychemotherapy. Consequently, strong GST-pi expression produced unfavourable prognostic factor for both patients on adjuvant chemotherapy (p=0.031, Log-rank test) and without p=0.049, Log-rank test). We propose here that strong GST-pi expression may lead to reduced efficacy of anticancer drugs or to inhibition of apoptosis, thus jeopardising survival of the patients.

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