原发性肝癌介入治疗与多药耐药基因表达的关系

The interventional therapy with relation multidrug resistance gene（ MDR1 ） in hepatocellular carcinoma

目的探讨原发性肝癌中多药耐药基因编码的P．糖蛋白（Pgp）表达对介入治疗疗效的影响。方法60例原发性肝癌按介入药物不同将患者分为TAE＋MMC＋ADM组（A组）20例，TAE＋5-FU＋DDP组（B组）20例和TArE＋LAK细胞组（C组）20例，采用链霉亲合索．生物素酶复合物（streptavidin-bioton complex，SABC）免疫组化方法检测Pgp表达。结果60例患者中Pgp阳性27例（45．0％），Pgp阴性33例（55．0％）；A、B、C组Pgp阳性表达率分别为9例（45．0％）、8例（40．0％）和9例（45．0％），Pgp阴性表达率分别为11例（55．0％）、12例（60．0％）和11例（55．0％）；A、B、C组Pgp阴性表达有效率为10例（50．0％）、9例（45．0％）和8例（40.0％），Pgp阳性表达5例（25．0％）、5例（30．0％）和5例（25．0％）；三组的Pgp阴性表达的有效率均高于Pgp阳性表达（均P〈0．05）。结论Pgp表达是影响介入疗效的重要因素，治疗前检测Pgp表达对制定个体化治疗方案有重要意义。

Objective To investigate the expression of P-glyeoprotein（Pgp） thant encoded by multidrug resistance gene（MDRl） and it＇s effect on interventional therapy of hepatocellular carcinoma（HCC）.Methods Biopsy was performed in 60 patients with HCC prior to transcatheter arterial ehemoembolization （TACE） and Pgp expression was detected by SABC immunohistochemieal method. According to different drug 60 patients divided into the A group（ n = 20） ,B group（n = 20） and C group（ n = 20）. Pgp expression was detected by streptavidin-bioton complex （SABC） immunohistochemical method. Results The expression of positive Pgp was 45.0 % and negative Pgp was 55.0 % in hepatocellular carcinoma;The expression of positive Pgp was 45.0 %, 40.0 %, 45.0 %, and negative Pgp was 55.0 % ,60.0 % and 55.0 % in A, B and C groups respectively; The efficiency rate in negative expression was 50.0 % ,45.0 % ,40.0 % and positive expression was 25.0 %, 30.0 % ond 25.0 % respectively; The efficiency rate in negative expression was obviously higher than that in positive expression to three groups（P 〈 0.05）. Conclusion The curative effect of interventional therapy is influenced by expression of Pgp. Detecting Pgp before treatment to TACE has instructive significance for interventional treatment according to individuals.