摘要
目的探讨食管癌细胞c-erbB-2与多药耐药性相关性及其临床意义。方法用免疫组化方法检测癌细胞c-erbB-2和用流式细胞术检测了46例食管癌手术标本中癌细胞P-糖蛋白(P-gp)表达水平,并进行相关性分析。结果食管癌中c-erbB-2表达阳性12/46例(26.1%),其中4例低度表达,8例中-高度表达;P-gp表达阳性28/46例(60.9%),其中6例低度表达,13例中度表达,9例高度表达。食管癌淋巴结转移情况与c-erbB-2和P-gp表达比较发现,在c-erbB-2阳性时淋巴结有转移(31.09±5.33)与无转移(8.04±3.03)组的P-gp表达比较差异有显著性(P<O.01)。食管癌临床分期与c-erbB-2和P-gp表达比较发现,在c-erbB-2阳性时Ⅲ—Ⅵ期(33.68±5.51)与Ⅱ期(9.30±2.78)组的P-gp表达比较差异有显著性(P<O.01)。食管癌肿瘤大小、肿瘤分化程度与c-erbB-2和P-gp表达均无相关性。结论在c-erbB-2表达阳性时食管癌中有淋巴结转移、临床Ⅲ—Ⅵ期患者与P-gp表达升高有相关性,提示双阳性时肿瘤患者预后较差。但在c-erbB-2表达阴性时食管癌有无淋巴结转移、临床分期与P-gp表达无相关性。
Objective： To investigate the correlation between c-erbB-2 and multidrug resistance （MDR） and its clinical significance, Methods： Immunohistochemistry stain was used to examine the expression of c-erbB-2 and flow cytometry was used to detect the expression of P-glycoprotein （P-gp） in samples from 46 patients with esophageal carcinoma. Results： The positive expression rate of c-erbB-2 was 26.1% （12/46） in the 46 cases of esophageal carcinoma, of which 4 cases being low expression and 8 cases mediumhigh expression. The positive expression rate of P-gp was 60.9% （28/46） in the 46 cases of esophageal carcinoma, of which 6 cases being low expression, 13 cases medium expression and 9 cases high expression. Comparing c-erbB-2 with P-gp expression in different lymph node metastasis statuses showed that there was significant difference （P〈0.01） between P-gp expressions with lymph node metastasis （31.09%±5.33%） and without lymph node metastasis （8.04%±3.03%） when c-erbB-2 expression was positive. Comparing c-erbB-2 with P-gp expression in different TNM stages of esophageal carcinoma showed that there was significant difference （P〈0.01） between P-gp expressions in HI Ⅳ stage （33.68%±5.51%）and in Ⅱ stage patients （9.30%±2.78%） when c-erbB-2 expression was positive. The tumor＇s size and differentiation degree were not related to c-erbB-2 and P-gp expression. Conclusion： The high level of P-gp expression was related to the positive expression of c-erbB-2 with the lymph node metastasis in clinical Ⅲ-Ⅳ stage patients of esophageal carcinoma, suggesting that the double positive might lead to a poor prognosis. However, when the c-erbB-2 expression was negative, the lymph node metastasis and clinical staging were not related to the P-gp expression in esophageal carcinoma patients.
基金
This work was supported by a grant from Zhejiang Medical and Health Research Foundation (No. 2000A017).
