三苯氧胺对淋巴细胞mdr1表达阳性的非小细胞肺癌患者多药耐药性的逆转作用

Reversal of drug sensitivity in human non-small cell lung carcinoma with mdr1 gene expressed in peripheral lymphocytes by Tamoxifen

目的:探讨经多次化疗的非小细胞肺癌(NSCLC)肿瘤细胞与外周血淋巴细胞(PBL)多药耐药基因(mdrl)表达蛋白P-gp含量及其相关性;临床观察三苯氧胺对已产生多药耐药的NSCLC患者耐药性的逆转作用.方法:应用流式细胞免疫学方法,对57例多次接受过化疗的NSCLC肿瘤组织细胞及PBL的P-gp含量进行定量研究,对PBL中P-gp表达阳性的48例患者均采用EMP方案化疗,其25例在化疗过程中同时予三苯氧胺口服,观察其临床治疗效果.结果:肿瘤细胞P-gp含量与其对应的PBL的P-gp含量呈正相关,PBL的P-gp含量可间接反应NSCLC细胞对化疗药物的耐受程度;三苯氧胺可部分逆转NSCLC细胞的耐药性,显著提高EMP方案对耐药的NSCLC患者的疗效.结论:通过检测NSCLC患者PBL P-gp的含量可间接反应肿瘤细胞的耐药程度,对已耐药的患者在化疗的同时合用三苯氧胺可明显提高化疗方案的有效率.

To explore the correlation of mdr1 gene expression-P-gp contents between non-small cell lung carcinoma(NSCLC) tissue cells and peripheral blood lymphocytes (PBL) and investigate the reversal of MDR in NSCLC by tamoxifen. Methods:The carcinoma tissue cells and PBL of 27 NSCLC patients accepted chemotherapy many times were contrasted their P-gp contents by flow cytometric-immunology. 21 cases of NSCLC confirmed P-gp content positive treated with EMP chemothera-py and 11 cases of them with tamoxifen at the same time. Results:The P-gp content of PBL were statistically related with that of NSCLC tissues cells. The P-gp content of PBL may indirectly indicate the multidrug resistance of NSCLC cells. Tamoxifen can partly reverse the mutidrug resistance of NSCLC and tamoxifen can increase the curative effect of NSCLC with P-gp positive. Conclusion:The P-pg content of PBL may indirectly indicate the multidrug resistance of NSCLC cells and the curative effect of NSCLC with P-gp positive can be increased by tamoxifen during the periods of chemotherapy.