非小细胞肺癌中不同作用机制耐药蛋白的表达及意义  

Expression and clinical significance of chemoresistance-related proteins acting in different mechanisms in non-small cell lung cancer

作　　者：朱建荣[1,2] 黄茂[1] 陆国础[2] 吴艳[2] 

机构地区：[1]南京医科大学第一附属医院呼吸科,江苏南京210029 [2]无锡市人民医院呼吸科,江苏无锡214023

出　　处：《南京医科大学学报（自然科学版）》2010年第8期1091-1096,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家自然科学基金资助(30700342)

摘　　要：目的:探讨非小细胞肺癌(non-small cell lung cancer,NSCLC)中耐药相关蛋白--肺耐药蛋白(lung resistance protein,LRP)、谷胱甘肽-S-转移酶π(glutathione-S-transferaseπ,GST-π)、核苷酸切除修复交叉互补基因1(excision repair cross-comple-tion group1,ERCC1)蛋白和凋亡抑制基因Survivin蛋白表达的临床意义。方法:用Envision免疫组化方法检测南京医科大学第一附属医院呼吸科64例病理确诊为NSCLC患者组织中LRP、GST-π、ERCC1蛋白和Survivin蛋白的表达情况,并将其与患者的病理类型、细胞分化程度、有无淋巴结转移、临床分期及铂类化疗效果等临床特征进行比较分析。结果:LRP、GST-π、ERCC1蛋白和Survivin蛋白的阳性表达率分别为60.9%、56.3%、60.9%和54.7%;NSCLC低分化组中LRP阳性表达率较高(85.0%),GST-π表达比例随分化程度降低而降低,ERCC1蛋白在鳞癌中表达显著增高(80.0%),Survivin蛋白在腺癌中表达显著增高(81.5%),均存在统计学差异(P<0.05);LRP与GST-π的表达呈正相关(R=0.262,P=0.036);回归分析表明LRP、ERCC1蛋白表达与化疗效果有关;且ERCC1蛋白阴性患者中,LRP阳性表达患者的化疗有效率显著降低(P<0.05)。结论:不同类型的NSLCL中,4种耐药相关蛋白的表达水平不同;LRP、GST-π存在协同表达;联合检测ERCC1蛋白、LRP能更好的预测NSCLC对铂类化疗的效果。Objective：To investigate the clinical significance and the expressions of the lung resistance protein（LRP）,glutathione-S-transferase π （GST-π）,excision repair cross-completion group 1 （ERCC1）protein and Survivin protein in non-small cell lung cancer （NSCLC）. Methods：LRP,GST-π,ERCC1 and Survivin protein in 64 specimens from NSCLC patients were detected using Envision immunohistochemical method,and the relationship was analyzed between the different protein expressions and the pathological classification,histological type,lymph node metastasis,clinical stage and the efficacy of platinum-based chemotherapy of NSCLC. Results： The positive rates of LRP,GST-π,ERCC1 protein and Survivin protein were 60.9%,56.3%,60.9% and 54.7% respectively. High expression of LRP was associated with poorly differentiated type （85.0%）. The positive rate of GST-π decreased with the degradation of differentiation degree of NSCLC. The significant high positive rate of ERCC1 protein was observed in squamous cell carcinoma （80.0%）. The positive rate of Survivin protein was significantly high in adenocarcinoma cell carcinoma （81.5%）. There were significant differences in those proteins expressions among different carcinoma types. There was a positive correlation between the expression of LRP and the expression of GST-π（R=0.262,P=0.036）. High expressions of ERCC1 protein and LRP were two independent factors related to platinum resistance by multivariate regression analysis. In ERCC1 negative NSCLC,the LRP positive patients’ remission rate of platinum-based chemotherapy was lower than the LRP negative patients’（P 0.05）. Conclusion：The expression levels of these proteins varied in different types of NSCLC. There was coordinate expression of LRP and GST-π. The combined detection of ERCCI and LRP proteins could be used to predict the sensitivity to platinum-based chemotherapy.

关 键 词：非小细胞肺癌 肺耐药相关蛋白 谷胱甘肽-S-转移酶Π 核苷酸切除修复交叉互补基因1 SURVIVIN 

分 类 号：R734.2[医药卫生—肿瘤]