4种耐药基因蛋白在中晚期喉癌放疗前后的表达及临床意义  

Expression and clinical significance of multidrug resistance protein in laryngeal cancer before and after radiotherapy

作　　者：李圆[1] 周雪华[1] 崔彩霞[1] 刘娟[2] 代丽丽[1] 刘亭彦[1] 陈朝辉[1] 魏庆宇[1] 

机构地区：[1]杭州师范大学附属医院耳鼻咽喉头颈外科,浙江杭州310015 [2]杭州师范大学附属医院病理科

出　　处：《中华全科医学》2016年第6期931-933,975,共4页Chinese Journal of General Practice

基　　金：浙江省自然科学基金(Y2100578);杭州市科技发展基金(20110833B09)

摘　　要：目的探讨P-糖蛋白(P-gp)、多药耐药相关蛋白(MRP1)、肺耐药相关蛋白(LRP)和谷胱甘肽-S转移酶(GST-π)在中晚期喉鳞状细胞癌患者放疗前后肿瘤组织中表达及放疗对喉癌耐药基因的影响。方法收集76例中晚期喉癌患者,其中低分化鳞状细胞癌8例,中高分化鳞状细胞癌68例,采用免疫组织化学法检测在不同类型喉癌组织和放疗前后癌组织中P-gp、MRP1、LRP和GST-π的表达强度和分布,分析其表达情况。结果喉鳞状细胞癌具有原发耐药性,P-gp在低分化鳞癌和中高分化鳞癌2种病理类型喉癌组织中呈高强度强阳性表达,与MRP1、LRP和GST-π三种耐药蛋白比较差异有统计学意义(F=8.0839,P=0.0438);MRP1在低分化鳞癌中的表达明显高于中高分化鳞癌中的阳性表达率,其差异有统计学意义(t=9.575,P<0.001);放射治疗后P-gp、MRP1、LRP和GST-π阳性表达率与放射治疗前相比均有增高,其中P-gp在放疗前后表达阳性率分别为(53.26±7.94)%、(79.37±7.73)%,表达差异有统计学意义(t=6.28,P<0.05);MRP1在放疗前后表达阳性率分别为(31.14±8.96)%、(54.76±9.53)%,差异有统计学意义(t=7.35,P<0.05)。结论 P-gp、MRP1、LRP和GST-π在喉鳞状细胞癌中表达存在差异性;放射治疗可以增加喉鳞状细胞癌耐药基因蛋白过表达,特别是放疗后P-gp和MRP1的过表达影响喉癌化疗方案的制定。Objective To explore the expressions of P-gp,MRP1,LRP and GST-π in patients with advanced laryngocarcinoma in tumor tissue before and after radiotherapy,and the effect of radiotherapy on laryngocarcinoma drug resistance gene. Methods Immunohistochemical method was used to detect the expression intensity and distribution of P-gp,MRP1,LRP and GST-π in 76 cases with advanced laryngocarcinoma before and after radiotherapy. Results Laryngocarcinoma has primary drug resistance,in different pathological types of laryngocarcinoma tissues,P-gp shows strong positive expression with high intensity,there was significant difference with the other three multidrug resistance proteins（ F =8. 0839,P = 0. 0438）. The positive expression rate of MRP1 in different pathological types of laryngocarcinoma tissues had significant difference（ t = 9. 575,P 〈 0. 001）,after radiation therapy,the positive expression rate of P-gp,MRP1,LRP and GST-π has increased,the expressions of P-gp and MRP1 had significant difference（ P 〈 0. 05）. Conclusion The expressions of P-gp,MRP1,LRP and GST-π in laryngocarcinoma are different,radiation can cause over-expressed laryngeal resistance gene protein,has influences on the formulation of laryngeal carcinoma chemotherapy.

关 键 词：喉癌 多药耐药 放疗 

分 类 号：R739.65[医药卫生—肿瘤] R730.55[医药卫生—临床医学]