鼻咽癌组织多药耐药基因的表达及其与化疗敏感性的关系  

Relationship between expression of multidrug-resistant genes in nasopharyngeal carcinoma tissue and sensitivity to chemotherapy

作　　者：陶仲强[1] 刘时才[2] 司勇锋[1] 张政[1] 周祥祯[2] 邓卓霞 周日晶[1] 黄波[1] 

机构地区：[1]广西壮族自治区人民医院耳鼻咽喉科,南宁530021 [2]广西壮族自治区人民医院病理科,南宁530021

出　　处：《中华耳鼻咽喉头颈外科杂志》2005年第3期203-207,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的探讨鼻咽癌组织的多药耐药基因的表达及其与化疗敏感性的关系. 方法应用单克隆抗体多药耐药基因蛋白(P-glycoprotein,P-gp)、多药耐药相关蛋白(multidrug resistance relation protein,MRP)、肺耐药相关蛋白(lung-resistance related protein,LRP)、拓朴异构酶(topoisomeerase Ⅱ,TopoⅡ)、胸腺肽合成酶(thymidylate synthase,TS)、谷胱甘肽转移酶(glutathione-S-transferase,GST-π),对23例鼻咽癌患者的肿瘤组织进行免疫组化检测.其中20例是治疗前鼻咽部原发灶活检组织,这20例患者用顺氯氨铂(diamminedichloroplatinum,DDP)+5-氟尿嘧啶(5-fluorouracil,5-FU)进行2个疗程化疗;3例是鼻咽癌治疗后颈部淋巴结复发,进行颈清扫术的标本. 结果除1例病理类型为透明细胞癌之外,各项多药耐药指标在22例患者中均有不同程度表达,成组秩和检验,各项的表达程度差异有统计学意义,P<0.05.不同细胞类型(原发鳞状细胞癌、泡状核细胞癌、透明细胞癌)和临床分期(Ⅱ～Ⅲ期)的多药耐药表达采用成组秩和检验差异无统计学意义(P值均>0.05).LRP和TS表达阳性分别是10例和14例,化疗有效率分别为20%(2/10)和28.5%(4/14);而表达阴性组化疗有效率分别为70%(7/10)和5/6,二者比较,P值均<0.05,差异有统计学意义. 结论免疫组化检测LRP和TS阳性鼻咽癌患者对DDP和5-FU化疗的敏感性可能较差.Objective To study the relationship between multidrug-resistant(MDR) expression in nasopharyngeal carcinoma (NPC) and its sensitivity to chemotherapy. Methods The specimems of 23 NPC cases were studied by immunohistochemistry with monoclonal antiboby of P-glycoprotein(P-gp),multidrug resistance relation protein(MRP), lung-resistance related protein(LRP),topoisomeerase Ⅱ(TopoⅡ),thymidylate synthase (TS),glutathione-S-transferase(GST-π).Among them, 20 specimens were taken from primary NPC lesion which were treated with two course of cisplatin(DDP) and 5-fluorouracil (5-FU), 3 specimens were taken from cervical lymph-node of recurrent NPC patients who were treated by radical dissection. Results Various MDR parameters were expressed differently in 22 cases except for 1 clear cell carcinoma case. The difference was statistically significant(P<0.05). However, there were no significant difference of MDR expression either among various carcinoma pathomorphology cell groups or among different clinical stage groups. Expression of LRP and TS were found in 10 and 14 cases respectively and the chemotherapy responders rates were 20%(2/10)and 28.5%(4/14) respectively. While the chemotherapy responders rates were 70%(7/10) and 5/6 in cases without expression. There was significant difference ((P<0.001, and P<0.05). ) Conclusion The NPC patients with LRP and TS expression may be less sensitive to chemotherapy with DDP+5-FU.

关 键 词：化疗敏感性 鼻咽癌组织 表达及 protein 多药耐药基因蛋白 多药耐药相关蛋白 免疫组化检测 肺耐药相关蛋白 谷胱甘肽转移酶 鼻咽癌患者 透明细胞癌 泡状核细胞癌 5-FU化疗 秩和检验 0.05 单克隆抗体 拓朴异构酶 TopoⅡ 

分 类 号：R739.63[医药卫生—肿瘤]