吉非替尼对表皮生长因子受体在胆管上皮细胞中表达的影响及意义  

Effects of Gefitinib on Expression of Epidermal Growth Factor Receptor in Bile Duct Epithelial Cells and Its Significance

作　　者：吴兴武[1] 徐亮[2] 秦昱[3] 侯昌映 徐茂林[3] 李富宇[4] 

机构地区：[1]双流县第二人民医院外三科,四川双流610200 [2]泸州医学院附属医院普外科,四川泸州646000 [3]双流县第一人民医院普外科,四川双流610200 [4]四川大学华西医院肝胆外科,成都610041

出　　处：《中国普外基础与临床杂志》2010年第5期469-473,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的通过观察吉非替尼对肝内病变胆管上皮细胞中表皮生长因子受体(EGFR)表达的影响,探讨抑制胆管上皮细胞过度增殖的可行性。方法选择双流县第一人民医院2006年8月至2008年8月期间住院需要手术的肝内胆管结石患者共61例,年龄25～65岁(平均46.92岁),随机分为治疗组和对照组。治疗组30例,术中在病变胆管内留置细导管,术后灌注吉非替尼溶液;对照组31例只作T管引流。分别于术中、术后6周和12周行胆道镜碎石及取石的同时,活检灌注处的病变胆管壁组织,行HE染色、免疫组化和RT-PCR检测,观察组织学变化和EGFR的表达。结果术中,2组胆管壁病理组织学改变及EGFR蛋白和mRNA表达无明显差异。术后6周和12周,治疗组的胆管黏膜上皮和黏膜下腺体增殖程度均较对照组明显减弱,EGFR蛋白表达较对照组明显减弱,EGFR mRNA表达明显低于对照组(P<0.05)。结论 EGFR在慢性增生性胆管炎中呈过表达状态,术后局部持续给予吉非替尼治疗能够特异性地阻断EGFR的激活和表达,能有效地抑制术后胆管上皮细胞的过度增殖。Objective To observe the effect of gefitinib on expression of epidermal growth factor receptor（EGFR） in bile duct epithelial cells,and the feasibility of inhibiting hyperplasia of bile duct epithelial cells with gefitinib.Methods Sixty-one patients with hepatolithiasis having to be in hospital for surgery from the First People＇s Hospital of Shuangliu county were selected,with 25-65 years old,average 46.92 years.The patients were randomly divided into therapy group and control group.There were 30 cases in therapy group,in which fine duct was placed on lesion bile duct during operation,and through whom gefitinib solution was perfused after operation.There were 31 cases in control group with only T tube drainage after operation.The bile duct sample was obtained respectively during the operation and 6 weeks and 12 weeks after operation.The histology and expression change of EGFR were observed by HE staining,immunohistochemistry and RT-PCR method respectively.Results There were no significant differences in pathohistology changes of bile duct and the EGFR protein and mRNA expression between therapy group and control group during operation.The hyperplasia of epithelium mucosae and submucosal gland in the therapy group were obviously decreased as compared with those in control group,the EGFR mRNA and protein expression in therapy group were weaker than those of control group（P〈0.05） 6 weeks and 12 weeks after gefitinib treatment.Conclusion EGFR is overexpressed in the chronic proliferative cholangitis,and continuously local application of gefitinib after operation can specifically interrupt the activation and expression of EFGR and then effectively inhibit the hyperplasia of bile duct epithelial cells.

关 键 词：肝内胆管结石 吉非替尼 表皮生长因子受体 胆管上皮细胞 慢性增生性胆管炎 免疫组化法 实时聚合酶链式反应法 

分 类 号：R657.4[医药卫生—外科学]