胃癌化疗组织学疗效与p53和P-糖蛋白表达及生存率关系的研究

The relation between the chemotherapeutic efficacy and p53,P-glycoprotein and survival time in patients with gastric cancer

目的探讨化疗组织学疗效与胃癌患者p53和P-糖蛋白表达及生存率的关系。方法采用SP免疫组织化学染色方法检测38例正常胃黏膜、18例未经术前动脉灌注化疗的胃癌组织和82例术前动脉灌注化疗的胃癌组织p53和P-糖蛋白的表达情况,并分析p53和P-糖蛋白表达与化疗组织学疗效和生存率的关系。结果p53和P-糖蛋白表达在正常组和胃癌组之间有统计学意义(P<0.05),在化疗组和未化疗组之间无统计学意义(P>0.05);化疗疗效与p53和P-糖蛋白的表达成负相关(P<0.01);生存期与组织学疗效成正相关(P<0.05);生存期与p53的表达成负相关(P<0.05),生存期与P-糖蛋白的表达无明显相关性(P>0.05);P-糖蛋白与p53的表达成正相关(P<0.01)。结论胃癌患者存在先天性多药耐药现象,术前检测P-糖蛋白与突变型p53的表达对胃癌的新辅助化疗具有重要的指导作用。

Objective To investigate the relation between the chemotherapeutic efficacy and the expression of p53, P-glycoprotein and survival time in patients with gastric cancer. Methods The expression of p53 and P-glycoprotein was detected by immunohistochemistry in 38 specimens of normal gastric mucosa, 18 gastric cancer tissue without artery infused chemotherapy and 82 gastric cancer tissue with artery infused chemotherapy. The correlation between the chemotherapeutic efficacy and the expression of p53, P-glycoprotein and survival time was analyzed. Results The difference in expression of p53 and P-glycoprotein was significant between normal gastric mucous membrane and gastric cancer tissue （P〈0.05） and there was significant difference in gastric cancer tissue with and without artery infused chemotherapy （P〉0.05）. The chemotherapeutic efficacy was negatively correlated with the expression of p53 and P-glycoprotein （P〈0.05）. Survival time was positive correlated with the chemotherapeutic efficacy P〈0.05）. Survivat time was negatively correlated with the expression of p53 （P〈0.05）. There was no correlation between survival time and the expression of P-glycoprotein （P〉0.05）. The expression of P-glycoprotein was positively correlated with the expression of p53 （P〈0.01）. Conclusion The expression of p53 and P-glycoprotein before operation might be helpful for guidance of chemotherapy in patients with gastric cancer.