乳腺癌组织中多药抗药基因表达的临床意义  

Clinical significance of expression of multidrug resistance gene in breast cancer tissue

作　　者：刘晓晴[1,2] 宋三泰[1,2] 石成华[1,2] 徐建明[1,2] 江泽飞 

机构地区：[1]军事医学科学院307医院肿瘤中心乳癌科 [2]军事医学科学院生物工程研究所

出　　处：《中华医学杂志》1997年第7期488-490,共3页National Medical Journal of China

摘　　要：探讨多药抗药ｍｄｒ－１基因在乳腺癌化疗抗药中的作用和地位。方法采用逆转录－多聚酶链式反应技术，检测了８２例次乳癌组织的ｍｄｒ－１ｍＲＮＡ水平。结果初治原发乳癌３５例，ｍｄｒ－１基因阳性表达３４．３％；复发转移乳癌４７例，ｍｄｒ－１基因阳性表达５９．６％。７例动态检测ｍｄｒ－１ｍＲＮＡ水平的患者，化疗后表达水平均高于化疗前。化疗有效组１８例，ｍｄｒ－１基因阳性表达１６．７％，其中高度阳性表达５．６％；化疗无效组１４例，ｍｄｒ－１基因阳性表达７１．４％，其中高度阳性表达５０．０％。结论复治转移乳癌比初治原发癌具有更普遍的抗药性，且主要是获得性抗药；ｍｄｒ－１基因表达可以作为预测化疗效果的一个参考指标。Objectives To investigate the role of expression of multidrug resistance gene (mdr 1 gene) in chemotherapeutic resistance of breast cancer and to determine if expression of mdr 1 gene may act as an index for predicting chemotherapy response and prognosis. Methods Using reverse transcription polymerase chain reaction (RT PCR) technique, we determined the levels of mdr 1 mRNA in 82 breast cancer samples. Results Positive expressions of mdr 1 gene were 34.3% in 35 cases of untreated primary breast cancer and 59.0% in 47 cases of relapsed metastatic breast cancer, separately, and the difference was statistically significant ( P <0.05). In 28 cases of relapsed metastatic breast cancer of mdr 1 gene positive expression, 22(78.6%) were ever treated with MDR related drugs. Levels of mdr 1 gene expression of all 7 cases were higher after chemotherapy than before chemotherapy. Positive expressions were 16.7% and high grade positive expressions were 5.6% in 18 sensitive cases. Positive expressions were 71.4% and high grade positive expressions were 50.0% in 14 resistant cases. The difference was statistically significant ( P <0.01). There were no relations between expression of mdr 1 gene and ages, menopause status, lymphnode involvements, clinical stages, and estrogen receptor levels. Conclusion The results indicated that retreated metastatic breast cancer is more extensively resistant than untreated primary breast cancer and acquired drug resistance is an important reason. Expression of mdr 1 gene seems to be a reference index for predicting response of chemotherapy.

关 键 词：乳腺癌 多药耐药 基因表达 MDR-1 

分 类 号：R737.905[医药卫生—肿瘤]