MDR1基因表达与肝癌患者TACE治疗反应性及预后的关系  

The association of efficacy of TACE and prognosis with MDR1 gene expression in patients with hepatic cancer

作　　者：吴照宇[1] 郭应兴[1] 雷进元[1] 于海东[1] 

机构地区：[1]青海大学附属医院介入科,青海西宁810001

出　　处：《肿瘤》2015年第3期340-345,共6页Tumor

基　　金：青海大学附属医院中青年科研基金(编号:ASRF-2009-23)~~

摘　　要：目的 :探讨肝癌中多药耐药基因1(multidrug resistance gene 1,MDR1)表达对经导管动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)治疗效果及预后的影响。方法 :对90例原发性肝细胞癌患者进行TACE治疗,并应用RT-PCR法检测肝癌组织中MDR1 m RNA的表达,比较不同组织学类型和分化程度的肝癌患者在TACE治疗前后MDR1阳性率变化,分析MDR1阳性和阴性患者的总有效率、中位生存时间、1年生存率和2年生存率,比较TACE治疗前后肝癌患者外周血谷草转氨酶、谷丙转氨酶、白蛋白、碱性磷酸酶、谷氨酰转肽酶、白细胞、红细胞、血红蛋白和血小板的变化。结果 :与TACE治疗前比较,TACE治疗后假腺管型和Ⅱ、Ⅲ、Ⅳ级肝癌组织中MDR1的阳性率均显著增加(P<0.01,P<0.01,P<0.05,P<0.05)。MDR1阴性组患者的总有效率、中位生存时间、1年生存率和2年生存率均高于MDR1阳性组(P<0.01,P<0.01,P<0.05,P<0.05)。TACE治疗后1个月,只有红细胞和血红蛋白指标未恢复正常。结论 :肝癌组织中MDR1的表达可能与TACE的治疗效果有关。Objective： To Investigate the gene 1 （MDR1） expression on chemoembolization （TACE） and effects of multidrug resistance efficacy of transcatheter arterial prognosis in patients with hepatic cancer. Methods： Ninety patients with primary hepatocellular carcinoma were treated with TACE. The expression of MDR1 mRNA was measured by RT-PCR. The positive expression rates of MDR1 in hepatic cancer patients with different histologic types and differentiation degrees before and after TACE were compared. The total response rates, median survival time, 1-year survival rate and 2-year survival rate of MDRl-positive and MDRl-negative patients with hepatic cancer were analyzed. The levels of aspartate transaminase, alanine transarninase, albumin, alkline phosphatase, gamma-glutamyl transpeptidase, white blood cell, red blood corpuscle, hemoglobin and platelet in peripheral blood of patients with hepatic cancer before and after TACE were compared. Results： The positive expression rates of MDR1 in pseudoglandular tissues and hepatic tissues with Ⅱ, Ⅲ and Ⅳ differentiation degrees increased significantly after TACE therapy, as compared with those before TACE therapy （P 〈 0.01, P 〈 0.01, P 〈 0.05, P 〈 0.05）. The total response rate, median survival time, 1-year survival rate and 2-year survival rate of MDR1- negative patients were higher than those of MDRl-positive patients （P 〈 0.01, P 〈 0.01, P 〈 0.05, P 〈 0.05）. One month after TACE therapy, only red blood corpuscle and hemoglobin levels did not return to normal levels. Conclusion： The expression of MDR1 in hepatocellular cancer tissues may be related to the efficacy of TACE.

关 键 词：肝肿瘤 多药耐药 预后 经导管动脉化疗栓塞 

分 类 号：R735.7[医药卫生—肿瘤]