胆囊和胆管癌组织中多药耐药相关蛋白和GST-π的表达及意义

Expression of multidrug resistance-related proteins MRP_1/MRP_2/GST-π in carcinoma of gallbladder and cholangiocarcinoma and its significance

背景与目的:多药耐药性(MDR)被认为是导致胆囊癌和胆管癌化疗疗效不佳的主要原因,本实验通过免疫组织化学的方法检测胆囊癌、胆管癌组织中MRP1、MRP2和谷胱甘肽S-转移酶-π(GST-π)的表达情况,并探讨其与耐药的关系。方法:采用免疫组化的方法(IHC)检测复旦大学附属中山医院普外科自2000年2月—2006年11月收治的并行手术切除的18例胆囊癌和36例胆管癌中MRP1、MRP2及GST-π的表达情况,并以胆囊炎和胆管炎13例为对照。结果:MRP1、MRP2和GST-π在胆囊癌组织中的表达阳性率分别72.2%、72.2%和61.1%,在胆管癌组织中的表达阳性率为86.1%、80.6%和69.4%,显著高于对照组的23.1%、15.4%和23.1%(P<0.05)。上述指标与性别、年龄、病理分期、病理类型、分化程度淋巴结转移均无关(P>0.05);MRP1和GST-π、MRP2在胆囊癌和胆管癌的表达具有相关性(P<0.05)。结论:MRP1、MRP2、GST-π在未经过化疗的胆囊癌和胆管癌组织中均有不同程度的高表达;胆囊癌和胆管癌的原发性多药耐药可能与MRP、MRP、GST-π有关。

Background and purpose： Multidrug resistance was the main cause for the patients with cholangiocarcinoma and carcinoma of gallbladder for not responding to chemotherapy. The objective of this paper was to investigate the expression of multidrug resistance-related proteinl/2（MRP1/MRP2）, glutathione S-transferase-π（GST-π） in carcinoma of gallbladder and cholangiocarcinoma. Methods： A total of 18 cases with carcinoma of gallbladder and 36 cases with cholangiocarcinoma were treated in the department of general surgery of Zhongshan Hospital（Shanghai） from Feb. 2000 to Nov. 2006, and another 13 cases of cholecystitis and choledochitis served as the control group. MRP1 ,MRP2 ,GST-π were measured by immuno- histochemistry method. Results： The positive rate of MRP1 ,MRP2 ,GST-π in carcinoma of gallbladder and cholangiocarcinoma were 72.2%, 72.2%, 61.1% and 86.1%, 80.6%, 69.4%, respectively, significantly higher than those of control group 23.1%, 15.4%, 23.1% （ P 〈 0.05）. Their expressions were not related to gender, age, staging, differentiation and lymph node metastasis（ P 〉 0.05）. The expression of MRP1 was related with expressions of GST-π and MRP2（ P 〈0.05）. Conclusions： MRP1 ,MRP2 and GST -π were overexpressed in various degrees in carcinoma of gallbladder and cholangiocarcinoma without chemotherapy, and may be related to the primary muhidrug resistance of the tumors.