P-糖蛋白在脑星形细胞瘤中的表达及意义  

Expression of P-Glycoprotein in Human Astrocytomas and Its Significance

作　　者：周荣福 侯卫东[2] 李飞[2] 冯华[2] 

机构地区：[1]重庆江北区第一人民医院神经外科,重庆400020 [2]第三军医大学第一附属医院神经外科,重庆400038

出　　处：《中国临床神经外科杂志》2007年第12期729-731,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家"十一五"科技支撑计划项目(2007DAI05D00);国家自然科学基金项目(30670506)

摘　　要：目的探讨脑星形瘤细胞P-糖蛋白(P-gp)的表达及临床价值。方法采用免疫组织化学法,对36例脑星形细胞瘤和3例来自颅脑损伤患者的脑组织及3例胎脑组织(作为对照)中P-gp的表达进行检测。对其中24例脑星形细胞瘤术后接受化疗患者的术后生存时间与P-gp表达的关系进行分析。结果P-gp在对照组6例脑组织中未见表达,而在36例星形细胞瘤中28例表达阳性,阳性表达率为77.8%,明显高于对照组(P<0.01)。在P-gp表达阳性的28例脑星形细胞瘤中,肿瘤细胞阳性表达9例,肿瘤间质血管内皮细胞阳性表达11例,二种细胞同时阳性表达8例。24例术后接受了化疗的患者中,6例P-gp表达阴性,18例表达阳性。在这24例病人中,P-gp表达阴性的病人术后5年生存率明显高于P-gp表达阳性者(P<0.05)。结论脑星形细胞瘤中P-gp不仅在肿瘤细胞表达,而且也在肿瘤间质血管内皮细胞表达,其对化疗药物的耐受性,存在肿瘤细胞和血脑屏障双重耐受机制,可能是脑星形细胞瘤产生多药耐受性的机理之一。P-gp的表达水平可能是影响病人术后化疗效果及术后生存时间的主要因素之一。Objective To explore the expression of P - glycoprotein （P-gp） in human astrocytomas and its clinical significance. Methods The expression of P-gp was determined by immunohistochemical technique in 36 cases of human astrocytomas, 3 cases of brain tissues derived from the patients with brain injury and 3 cases of fatal brain tissue. The relationship between survival time and P- gp expression was analyzed in 24 patients with astrocytomas receiving chemotherapy after the surgery. Results P-gp expression was not observed in the brain tissues derived from the patients with brain injury and the fatal brain tissues. The positive expression of P-gp was observed in 28 of 36 cases of astrocytomas. The positive expression of P-gp was observed only in the tumor cells of 9 of 28 cases of astrocytomas with positive expression of P-gp, only in the vascular endothelium cells of 11 and in both the tumor cells and Vascular endothelium cells of 8. Of 24 samples of astrocytomas intraoperatively derived from the patients receiving postoperative chemotherapy, 6 had negative expression of P-gp and 18 positive. In 24 patients receiving chemotherapy, the 5 -year survival rate in the patients with astrocytomas where the positive expression of P-gp was observed was significantly lower than that in the ones with astrocytomas where the negative expression of P-gp was observed （P〈0.05）. Conclusions P-gp may be expressed in both the tumors and vascular endothelial cells of astrocytomas. P-gp may be one of the factors affecting the resistance of astrocytoma to chemotherapy. The expression level of P-gp may be related to the effect of postoperative chemotherapy on the tumors and survival time in the patients with astrocytomas.

关 键 词：P-糖蛋白 脑星形细胞瘤 化疗 耐药 

分 类 号：R739.41[医药卫生—肿瘤] Q786[医药卫生—临床医学]