胃癌耐药基因的表达及其在药物适配个体化治疗中的意义

The expression of drug resistance genes in gastric carcinoma and their significance in pharmic fitting individuality chemotherapy

目的 检测人体胃癌组织中肿瘤抑制基因和耐药基因的表达情况 ,对不同个体化疗中采用的药物与耐药基因适配与否及疗效进行初步研究。方法 应用免疫组织化学方法检测 66例胃癌组织中 p5 3、P gp、GST л、TopoⅡ表达情况 ,并分析其与相关临床资料的关系。 结果 66例胃癌标本中 ,p5 3表达与肿瘤的TNM分期无关 ;P gp阴性与表达率患者年龄呈正相关(P <0 .0 5 ) ;胃癌的浸润深度与GST л阴性和TOPOⅡ阴性呈正相关 (P <0 .0 5 )。4种被检测基因中p5 3与GST π ,P gp与GST л的表达具有相关性(P <0 .0 5 )。结论 目前采用的常规联合化疗方案有效率低 ,需要改进。根据耐药基因的检测结果针对不同患者 ,实施科学的、药物适配的个体化化疗方案。

Objective To detect the expression of p53,P gp,GST π,TopoⅡ in human gastric cancer and explore their clinical significance in chemotherapy by studying whether drugs used by different patient fit the correlative drug resistance genes and curative effect.Methods By using immunohistochemical assay,the expression of p53,P gp,GST π,Topo Ⅱ was detected in 66 patients with gastric cancer.The correlation between the expression and related clinical data was analyzed.Results The total positive rate of p53 was 48.5% (32/66).There was no significant correlation between the expression and pathologic TNM stage.The positive rate of P gp was 28.8% (19/66),and its negative expression rate was significantly correlated with age ( P <0.05).The total positive expression rate of GST π was 43.9% (29/66) and the positive rate of Topo Ⅱ was 27.3% (18/66) respectively.There were significant correlations between the negative expression of both GST π and Topo Ⅱ and the depth of invasion ( P <0.05).Among the 4 detected genes,p53 was correlated with the expression of GST π and Topo Ⅱ.Conclusion The routine,joint chemotherapies need improve on because of their low efficiency.The different,pharmic fit,scientific individuality chemotherapy made by the detection of drug resistance genes for gastric cancer patient.