P—gp、GST-π、Topo—Ⅱ在胃癌组织中的表达及对新辅助化疗疗效的影响  

Study on the relationship between the expression of P-gp, GST-π, and Topo- II and the efficacy of the neuadjuvant chemotherapy in the patients with gastric cancer

作　　者：曾辉[1] 龚晓成 韩建伟[1] 许朝阳[2] 

机构地区：[1]浙江大学附属第二医院建德分院普外科,浙江省建德311600 [2]浙江大学附属第二医院建德分院病理科,浙江省建德311600

出　　处：《中国医师杂志》2013年第12期1650-1653,共4页Journal of Chinese Physician

摘　　要：目的探讨P糖蛋白（P—gp）、谷胱甘肽-S-转移酶（GST-π）及拓扑异构酶Ⅱ（Topo-Ⅱ）蛋白在胃癌组织中的表达及其与新辅助化疗之间的关系。方法通过免疫组化方法检测43例患者胃癌组织中P—gp、GST-百及Topo—Ⅱ蛋白的表达水平，分析其与胃癌临床病例特征的关系。将P—gp表达阳性、GST-π表达阳性和Topo-Ⅱ表达阴性作为3个可能的危险因素，将人组患者分成高危耐药组（2—3个危险因素）和低危耐药组（0—1个危险因素），比较两组患者新辅助化疗的有效率。结果P—gp阳性表达率为41．9％，与胃癌临床病理因素均无关（P〉0．05）；GST-订阳性表达率为44．2％，与胃癌分化程度有关（χ2=5．58，P〈0．05）；Topo—Ⅱ阳性表达率为72．1％，与胃癌的分化程度有关（χ2=9．07，P〈0．01）。3种蛋白各自表达的阳性组和阴性组比较，新辅助化疗的有效率比较差异均无统计学意义（P〉0．05）。高危耐药组24例（55．8％），低危耐药组19例（44．2％）。高危耐药组新辅助化疗有效率明显低于低危耐药组（P〈0．05）。结论胃癌组织中P．gP、GST-π和Topo-Ⅱ蛋白的表达与新辅助化疗的有效性有关，对于高危耐药的患者行新辅助化疗不能提高手术切除率。Objective To explore the relationship between neoadjuvant chemotherapy and the expression of P-glyeoprotein （P-gp） , glutathione-S-transferase-π（ GST-π）, and topoisomerase II （Topo-Ill ） in gastric carcinoma. Methods The expressions of P-gp, GST-π, and Topo- II in 43 patients with gastric carcinoma were detected by immunohistochemistry. The relationship of those gene expressions and the pathological data was analyzed. The positive expression of P-gp and GST-π, and the negative expression of Topo-II were considered as risk factors. Patients were divided into two groups： a high risk drug-resistant group （2 - 3 risk factors） and the low risk drug-resistant group （0 - 1 risk factors）. The efficacy of neoadjuvant chemotherapy was compared between two groups. Results The positive rate of P-gp was 41.9%, and there was no relationship between the P-gp expression and the pathological factors. The positive rate of GST-π was 44. 2%, and the high expression of GST-π was significantly correlated with differentiated degree of tumor （ X： = 5.58 ,P 〈 0.05）. The positive rate of Topo- II was 72. 1% , and the high expression of Topo-II was significantly correlated with differentiated degree of tumor （χ2 = 9. 07 ,P 〈0. 01 ）. There were no significant differences in the efficacy of neoadjuvant chemotherapy between the positive and negative groups of three proteins （ P 〉0.05）. There was 24 cases （55.8%） in the high risk drug-resistant group. There were 19 cases （44.2%） in the low risk drug-resistant group. The efficacy of neoadjuvant chemotherapy with patients in the high risk drug-resistant group was much lower than that with patients in the low risk drug-resistant group（ P 〈 0. 05）. Conclusions The expressions of P-gp, GST-π, and Topo- II were associated with the efficacy of neoadjuvant chemotherapy. Neoadjuvant chemotherapy appeared to be more beneficial to patients with low risk drug-resistance.

关 键 词：DNA拓扑异构酶类 Ⅱ型 代谢 P糖蛋白类 代谢 谷胱甘肽转移酶 代谢 胃肿瘤 代谢 免疫组织化学 化学疗法 辅助 

分 类 号：R735.2[医药卫生—肿瘤]