卵巢上皮性癌P-糖蛋白表达及其与化疗耐药性的关系

P glycoprotein expression in ovarian cancer and its relation to chemotherapy resistance.

目的：了解多药耐药ＭＤＲ基因在卵巢癌中的表达及表达产物Ｐ－糖蛋白（Ｐ－ｇｐ）与化疗耐药性的关系。方法：用免疫组化法测定卵巢癌５４例手术切除肿瘤组织Ｐ－ｇｐ的表达情况，分析其与临床、病理及化疗效果的关系。结果：Ｐ－ｇｐ表达阳性者２４例，占４４．４％，Ｐ－ｇｐ表达与临床分期、病理分级、术后残余瘤大小无关。Ｐ－ｇｐ阳性与阴性者所接受的化疗无差异。术前用过与ＭＤＲ有关药物化疗者，Ｐ－ｇｐ阳性率为６９．２％，高于未化疗者（３６．６％）。Ｐ－ｇｐ阳性者化疗近期疗效差，化疗有效率为４７．１％，低于Ｐ－ｇｐ阴性者的８１．８％，但两组预后无差异。结论：测定Ｐ－ｇｐ表达有助于预测肿瘤的耐药性及指导化疗药物的选择。Ｐ－ｇｐ表达是化疗耐药原因之一。

Objectives: To determine P glycoprotein expression in epithelial ovarian cancers and to analyze the relation between P glycoprotein and drug resistance in the chemotherapy of ovarian cancers. Methods:Immunohistochemical staining of P glycoprotein expression was performed on specimens from 54 epithelial ovarian cancer patients,and the patients were followed up.The relation of P glycoprotien expression to clinicopathologic features,response to chemotherapy,and prognosis of these patients were analyzed. Results: Twenty four out of 54 tumors expressed P glycoprotein(44.%),P glycoprotein expression was not related to other prognostic factors such as stage,grade,histologic types and residual tumor size,and the chemotherapy was not different in the patients with positive or negative P glycoprotein expression.The positive rate of P glycoprotein expression was 69.2% in the tumors treated with agents related to multidrug resistance,and 36.6% in previously untreated tumors.The reponse rate to chemotherapy was higher in the group with negative P glycoprotein expression(81.8%)than that in the group with positive P glycoprotein expression(47.1%), P <0.05.P glycoprotein expression was not associated with prognosis of these patients Conclusions:The positive staining for P glycoprotein is one of the determinants involved in the chemoresistance of ovarian cancer,the determination of P glycoprotein can be helpful in the prediction of cellular resistance to chemotherapy,and in the choose of antitumor agents.