多药耐药基因蛋白在贲门癌组织中的表达及其临床价值  

Expression of P-glycoprotein, glutathione S-transferase-π, topoisomerase II and lung resistance protein in cardiac carcinoma and their clinical significances

作　　者：史宏灿 石维平 束余声 陆世春 王康 顾学文 田秀春 

机构地区：[1]扬州大学临床医学院胸心外科,江苏省扬州市225001 [2]扬州大学临床医学院病理科,江苏省扬州市225001

出　　处：《世界华人消化杂志》2006年第16期1587-1591,共5页World Chinese Journal of Digestology

摘　　要：目的:研究耐药基因P-糖蛋白(P-gP)、谷胱甘肽S-转移酶(GST-π)、拓朴异构酶Ⅱ(Topo-Ⅱ) 和肺耐药相关蛋白(LPR)在贲门癌组织中表达及其临床意义．方法:采用免疫组化SP法检测P-gP,GST-π, Topo-Ⅱ和LRP在69例贲门癌组织中的表达状况结果:P-gp,GST-π,Topo-Ⅱ和LRP在贲门癌组织中阳性表达分别为49．2％,75．4％,68．1％和58％,均高于正常组织(0,30％,20％和0, P<0．01)．随分化程度由高到低,P-gp阳性表达率分别为40％,42．4％,61．5％,差异无显著意义(p>0．05),GST-π表达率分别为40％,75．8％和88．5％,差异有显著意义(P<0．05),Topo-Ⅱ表达率分别为33．3％,69．7％和80．7％,差异有显著意义(P<0．01),LRP表达率分别为50％, 54．5％和65．3％,差异无显著意义(P>0．05)．临床分期Ⅰ、Ⅱ期和Ⅲ、Ⅳ期中,P-gp阳性表达率分别为28．6％和58．3％,差异有显著意义 (P<0．05),GST-π表达率分别为57．1％和83．2％, 差异有显著意义(P<0．05),Topo-Ⅱ表达率分别为57．1％和72．9％,差异无显著意义(P>0．05), LRP表达率分别为38％和66．6％,差异有显著意义(P>0．05)．在有无淋巴结转移分组中,P-gp 阳性表达率分别为67．5％和24．1％,差异有显著意义(P<0．01),GST-π表达率分别为87．5％和58．6％,差异有显著意义(P<0．05),TOpo-Ⅱ表达率分别为65％和72．4％,差异无显著意义 (P>0．05),LRP表达率分别为70％和41．4％,差异有显著意义(P<0．05)．四种耐药基因在贲门癌组织中存在共同表达．结论:贲门癌存在多个耐药基因的共同表达, 联合检测有助于对化疗药物敏感性作前瞻性预测和化疗方案的优化组合．AIM： To investigate the expression of multidrug resistant proteins and their clinical significances in cardiac carcinoma tissues. METHODS： The expression of P-glycoprotein （P-gp）, glutathione S-transferase-π（GST-π）, topoisomerase II （Topo-II） and lung resistance protein （LRP） in 69 patients with cardiac carcinoma were determined by SP immunohistochemistry,and the results were studied in correlation with clinicopathological data. RESULTS： The positive rates of P-gp, GST-π, Topo-II and LRP expression in cardiac carcinoma （49.2%, 75.4%, 68.1% and 58%, respectively）were all higher than those in the normal tissues （0, 30%, 20% and 0, respectiveiy, all P〈0.01）. The expression of P-gp was correlated with clinical staging （I, II vs III, IV： 28.6% vs 58.3%, P〈0.05） and lymphatic metastasis （metastasis vs non-metastasis： 67.5% vs 24.1%, P〈0.01）. A significant correlation was found between GST-π and differentiated degree （40%, 75.8% and 88.5% for high, moderate, and low differentiation, respectively, P 〈 0.05）, clinical staging （ I, II vs III, IV： 57.1% vs 83.2%, P 〈 0.05） and lymphatic metastasis （metastasis vs non-metastasis： 87.5% vs 58.6%, P 〈 0.05）. The level of Topo-II expression was associated with differentiated degree （33.3%, 69.7%, and 80.7%, for high, moderate, and low differentiation, respectively, P〈0.01）, but not with the clinical staging （P〉0.05） and lymphatic metastasis （P〉0.05）. LRP expression was in correlation with the clinical staging （ I, II vs III, IV： 38% vs 66.6%, P 〈 0.05）, and lymphatic metastasis （metastasis vs non-metastasis： 70.0% vs 41.4%, P〈0.05）. CONCLUSION： Primary multidrug resistance coexists in cardiac carcinoma. Combined determination of P-gp, GST-π, Topo-II and LRP is useful for predicting the chemosensitivities and optimizing the chemotherapy strategies.

关 键 词：贲门癌 多药耐药 P-糖蛋白 谷胱甘肽S-转移酶 拓朴异构酶-Ⅱ 肺耐药相关蛋白 

分 类 号：R735.2[医药卫生—肿瘤]