Glutathione S-transferase expression in malignant mesothelioma and non-neoplastic mesothelium: an immunohistochemical study.

Expression of the glutathione S-transferase (GST) subclasses alpha, mu and pi was investigated immunohistochemically in 20 normal or hyperplastic mesothelium and in 57 malignant mesothelioma cases. These results were correlated with survival and also with P-170 glycoprotein expression. Nearly all the non-neoplastic mesothelium cases were positive for GST alpha and pi. About half of the non-neoplastic cases were positive for mu. Twenty-nine (51%) malignant mesotheliomas were positive for at least one of the GST species; 21 (37%) showed immunoreactivity for alpha, 18 (31.5%) for mu and 21 (37%) for pi. A total of 54 mesothelioma cases displayed immunoreactivity for the P-170 glycoprotein. For GST pi and GST mu, a statistical significance between expression and increased survival was found (respectively P = 0.012 and 0.024) while for GST alpha no significance was found. The results of this study demonstrate that expression of GST pi correlates positively with increased survival in malignant mesothelioma. It is also concluded that, in mesothelioma, GST and P-170 glycoprotein may contribute to the resistance to cytotoxic drugs frequently observed in these tumours. No correlation between GST and P-170 expression was demonstrated.