肺癌中p53及nm23与多药耐药基因表达的相关分析及预后意义

Relationship between expression of p53,nm23 and multidrug resistance gene in lung cancer and their prognostic significance

目的探讨肺癌中p53和nm23与GST Pi、ToPoⅡ、P gp表达的相关性及预后意义。方法用免疫组化法对76例肺癌进行p53、nm23、GST Pi、ToPoⅡ和P gp检测分析,并随访。结果76例肺癌中p53、nm23、GST Pi、ToPoⅡ、P gp的阳性表达率依次为76.3%、17.1%、51.3%、25.0%和15.8%。p53和nm23表达与GST Pi、ToPoⅡ、P gp三种耐药基因表达无关(P>0.05),与淋巴结转移相关(P<0.01)。三种耐药基因的阳性表达与肺癌的组织学类型相关(P<0.05),与淋巴结转移及临床分期相关(P≤0.01),与性别、年龄无关(P>0.05)。结论部分肺癌患者体内存在多药耐药基因(MDR1)或对GST Pi、ToPoⅡ、P gp介导的抗癌药物已产生耐药。p53及nm23在肺癌中的表达与多药耐药无关;与淋巴结转移呈负相关,对判断肺癌的预后有重要意义。肺癌中多药耐药基因的表达与组织学类型、淋巴结转移、临床分期相关。

Objective To explore the relationship between expression of p53,nm23 and multidrug resistance genes GST-Pi, ToPo-Ⅱ, P-gp in lung cancer and their prognostic significance.Methods Immunohistochemistry was used to detect the expression of p53, nm23 ,GST-Pi, ToPoⅡ and P-gp in 76 cases of lung cancer.All the cases were followed up.Results In 76 cases of lung cancer, the positive expression rates of p53, nm23, GST-Pi,ToPoⅡ and P-gp were 76.3%, 17.1%, 51.3%, 25.0% and 15.8%, respectively.There was no significant relationship between expression of p53, nm23 and resistance genes GST-Pi, ToPoⅡ, P-gp in all cases(P>(0.05)).There was significant relationship between expression of p53, nm23 and axillary lymph node metastasis(P<0.01).The expression of resistance genes GST-Pi, ToPoⅡ,P-gp was related to tissue types of the cancer, axillary lymph node metastasis and clinical stage of the lung cancer(P<0.05), but had no statistical relationship with gender and age (P>(0.05)).Conclusions Some lung cancer patients have primary positive expression of GST-Pi, ToPoⅡ, P-gp genes which cause intrinsic multidrug resistance.The expression of p53 and nm23 has no relation with multidrug resistance genes GST-Pi, ToPoⅡ, P-gp,but has negative correlation with axillary lymph node metastasis, which is useful to the judgement of prognosis.The expression of multidrug resistance genes GST-Pi, ToPoⅡ and P-gp is related to tissue types of the cancer, axillary lymph node metastasis and clinical stage of the cancer.