原发性肾癌mdr－1基因产物的表达及临床意义

Expression of mdr-1 gene product in primary renal cell carcinoma and its clinical significance

为探讨肾癌的耐药规律，我们应用ＬＳＡＢ免疫组织化学方法研究了３４例原发性肾癌，２０例正常肾组织多药耐药基因（ｍｄｒ－１）产物Ｐ－糖蛋白（Ｐ－ＧＰ）的表达情况。结果表明：１００％的正常肾组织有Ｐ－ＧＰ的表达，以肾近曲小管的表达最强，远曲小管次之。８５．３％的肾癌组织有Ｐ－ＧＰ的表达。Ｒｉｄｉｔ统计学检验显示Ｐ－ＧＰ的表达与肾癌的组织分级、病理分期无关。研究显示：肾小管是Ｐ－ＧＰ高表达的组织，因此起源于肾小管的肾细胞癌表现高耐药性。消除Ｐ－ＧＰ介导的多药耐药机制的影响是提高肾癌化疗效果的关键。

The response of renal cell carcinoma (RCC)to chemotherapy has been a perplex problem.To probe into the principles of drug-resistance in primary RCC,the expression of mdr-1 gene product, the intrinsic drug-resistence related p-glycoprotein,was studied with labelled strep-avidin biotin (ISAB)immunohis tochemical method in 34 cases of RCC and 20 normal kidneys. The results were that p-glycoprotein was expressed in all normal kidneys,especially in proximal tubule,and in 85.3%cases of RCC.No statistical correlation was found between the staining density of p-glycoprotein and the grade,and stage of RCC.The results suggested that renal tubule was the site where p-glycoprotein expressed at high levels,so that RCC arised from renal tubule would also express p-glycoprotein at high levels. To remove the influence of multidrug resistance conducted by p-glycoprotein would be the key point to increase the effect of chemotherapy in RCC.