^(99m)Tc-甲氧基异丁基异腈在人肺癌组织中的摄取与多药耐药基因表达的相关性研究  

Correlation of the uptake of technetium-99m methoxyisobutyl isonitrile with expression of multidrug resistance genes mdr-1 and MRP in human lung cancer

作　　者：史德刚[1] 黄钢[2] 苗积生[3] 林祥通[1] 

机构地区：[1]复旦大学附属华山医院核医学科 [2]上海第二医科大学附属仁济医院核医学科 [3]上海市肺科医院核医学科

出　　处：《中华医学杂志》2002年第12期824-827,共4页National Medical Journal of China

摘　　要：目的　探讨甲氧基异丁基异腈 (MIBI)在人肺癌组织中的摄取与多药耐药基因 (mdr 1)和多药耐药相关蛋白 (MRP)基因表达之间的相关性 ,用以指导临床化疗。方法　研究对象为 2 7例肺癌患者。 18例静脉注入99mTc MIBI 1110MBq ,6 0和 12 0min后分别作胸部双探头单光子发射型计算机断层显像 (SPECT) ,根据病灶和对侧正常肺组织的计数率比值 ,计算出99mTc MIBI在肺癌组织中的早期显像摄取比值、延迟显像摄取比值和储留指数。用逆转录聚合酶链反应技术检测 2 7例患者手术切除标本中mdr 1和MRP基因的表达 ,表达量以mdr 1或MRP条带与内参照 β2 微球蛋白条带的吸光度值之比表示。结果　肺癌患者胸部99mTc MIBI早期显像的阳性率为 83 3% (15 / 18) ;阳性者摄取比值为 1 99± 0 6 4 ,其中 13例作了延迟显像 ,经过时间衰变校正后 ,其99mTc MIBI摄取比值和储留指数分别为 2 0 6± 0 6 9和 - 4 5 %～ 33%。手术切除的肺癌组织中mdr 1和MRP基因表达阳性率分别为2 2 2 % (6 / 2 7)和 6 3 0 % (17/ 2 7) ,表达量分别为 0 39± 0 10和 0 2 3± 0 17;癌旁正常肺组织中mdr 1和MRP基因表达的阳性率分别为 35 0 % (7/ 2 0 )和 4 5 0 % (9/ 2 0 ) ,表达量分别为 0 4 4± 0 14和 0 17±0 18。Objective To investigate the relationship between the uptake of technetium 99m methoxyisobutyl isonitrile ( 99m Tc MIBI) and the expression of multidrug resistance genes mdr 1 and MRP in lung cancer so as to guide chemotherapy Methods Eighteen lung cancer patients were given 1 110 MBq 99m Tc MIBI intravenously Chest single photon emission computed tomography was performed 60 and 120 min after the injection The early and delay uptake rates,and retain index of 99m Tc MIBI were calculated by the count ratio of the lung lesion to contralateral normal lung tissue The expressions of mdr 1 and MRP genes in specimens of lung cancer and normal lung tissues near the cancers resected during operation among the 27 patients were detected with RT PCR method Results The positive rate of 99m Tc MIBI in the chest of lung cancer patients was 83 3% (15/18) The early uptake ratio of imaging in lung cancer patients was 1 99±0 64 After time decay correction, the rate of target to background and the retain index in 13 delay imagings were 2 06±0 69 and -45%～33% respectively In specimens of lung cancer, the positive expression rates of mdr 1 and MRP were 22 2%(6/27) and 63%(17/27) with the expression amount of 0 39±0 1 and 0 23±0 17 respectively In specimens of normal lung tissues near lung cancer, the positive expression rates of mdr 1 and MRP genes were 35%(7/20) and 45 0%(9/20) with the expression amount of 0 44±0 14 and 0 17±0 18 respectively In lung cancer tissues, the positive rate of MRP was higher than that of mdr 1 ( P <0 05), however, in the tissues near lung cancer, no significant difference was found between the positive rate of MRP and that of mdr 1( P >0 05) There was no marked correlation ( P >0 05)among the co expression or expression of mdr 1 and/or MRP and the early uptake or retain index in lung cancer Conclusion The primary chemoresistance of lung cancer has not significant correlation to the expression of multidrug r

关 键 词：肺肿瘤 ^99m锝Sestamibi 基因表达 相关性研究 肺癌 多药耐药基因 

分 类 号：R734.2[医药卫生—肿瘤]