消化道肿瘤转移淋巴结凋亡抑制蛋白表达与化疗药敏性的关系  

RELATIONSHIP BETWEEN EXPRESSION OF INHIBITORS OF APOPTOSIS PROTEINS AND CHEMOSENSITIVITIES IN LYMPH NODE METASTASES OF GASTROINTESTINAL CARCINOMA

作　　者：王安峰[1] 韩杰[2] 檀碧波[2] 耿玮[2] 吕炳蓉[2] 赵建辉[2] 

机构地区：[1]河北医科大学第三医院放疗科,河北石家庄050051 [2]河北省人民医院胃肠外科,河北石家庄050051

出　　处：《河北医科大学学报》2010年第2期143-146,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(08023);河北省科技计划基金资助项目(06276102D-73)

摘　　要：目的探讨消化道肿瘤淋巴结转移灶凋亡抑制蛋白表达与化疗药物敏感性的关系。方法对54例胃癌、大肠癌新鲜肿瘤组织及转移淋巴结进行肿瘤细胞培养化疗药敏性实验,原发灶和转移灶行P53、survivin、bcl-2免疫组织化学染色。结果①原发、转移灶survivin表达一致率较低为24.1%(P>0.05);P53、survivin、bcl-2在淋巴结转移灶、原发灶表达强度差异无统计学意义(P>0.05);P53、bcl-2在原发灶与转移淋巴结间表达具有明显相关性(P<0.05)。②9种化疗药物对原发灶、转移灶肿瘤细胞的平均抑制率不同。长春新碱、羟基喜树碱、奥沙利铂、顺铂、甲氨蝶呤对转移淋巴结肿瘤细胞抑制率均明显低于原发灶(P<0.05),仅足叶乙甙对原发灶的抑制率明显低于转移灶(P<0.05)。③肿瘤原发灶及转移灶P53表达程度与9种药物的平均抑制率均无相关性(P>0.05)。survivin在原发灶、转移灶表达程度分别与长春新碱和足叶乙甙、紫杉醇的抑制率呈负相关(P<0.05);原发灶、转移灶bcl-2表达程度分别与5-氟脲嘧啶、紫杉醇和足叶乙甙、羟基喜树碱、紫杉醇、奥沙利铂、表阿霉素的抑制率呈负相关(P<0.05)。结论消化道肿瘤淋巴结转移灶凋亡抑制蛋白表达程度及化疗药敏性均呈现与原发灶不同的异质性,术后辅助化疗靶目标应针对淋巴结转移灶。Objective To investigate the relationship between expression of inhibitor of apoptosis proteins and ehemosensitivities in lymph node metastases（LNMs） of gastrointestinal carcinomas. Methods The chemosensitivities to 9 drugs were measured by methyl thiazolyl tetrazolium（MTT） assay, and the expression of P53, survivin and bcl-2 were determined immunohistochemically in 54 paired primary tumor （PT） and LNMs of gastrointestinal carcinomas. Results The lower accordance in expression of survivin was seen in 24.1% between PT and LNMs（ P 〈0.05）. There were no significant difference in expression of P53,survivin or bcl-2 between PT and I.NMs （ P 〉0.05）. The inhibition rates of LNMs cells for vincristine （VCR）, hydroxycamptotheein （OPT）, oxaliplatin （OXA）, cisplatin （DDP） and methotrexate （MTX） were lower than those of PT （P 〈0.05）, only for etoposide （VP-16） higher （P〈0.05）. Expression of P53 in PT and LNMs was not correlative with the inhibitions rates for 9 drugs （ P 〉0.05）. There was statistically negative correlation between expression of survivin and inhibition rates of PT for VCR （ P 〈0. 050 ,and of LNMs for VP-16 and paclitaxel （PTX） （ P 〈 0.05） respectively. Expression of bcl-2 in PT was negative correlation with inhibition rates for 5- fluorouracil （5-FU） and PTX （ P〈0.05）, and also in LNMs for VP-16, OPT, PTX, OXA and epirubiCin （eADM） （P 〈 0.05）. Conclusion The LNMs of gastrointestinal carcinomas are heterogeneous with respect to expression of inhibitor of apoptosis proteins and response to chemotherapy. Effective adjuvant chemotherapy in gastrointestinal cancers depends on targeting the metastatic component of the disease.

关 键 词：胃肠道 肿瘤 淋巴结 

分 类 号：R735[医药卫生—肿瘤]