食管癌细胞体外培养药敏试验与P—gp、LRP表达的相关性研究

Correlation between chemosensitivity testing and expression of P-gp, LRP in esophageal carcinoma cell cultured in vitro

目的研究不同食管癌患者对药物的敏感性及其与P-糖蛋白（P—gp）、肺耐药相关蛋白（LRP）的关系，为食管癌的临床化疗提供个体化用药的实验室依据。方法选取手术切除的新鲜食管癌组织标本，选用食管癌化疗常用的药物及化疗方案进行食管癌原代培养细胞MTT药物敏感试验，同时应用免疫组织化学方法检测食管癌细胞P—gp及LRP的表达情况。结果单一用药对食管癌细胞的敏感性不同或不完全相同（P〈0．05）。联合用药以紫杉醇联合顺铂效果最好，其次为顺铂联合长春瑞滨、顺铂联合5-氟尿嘧啶。顺铂的敏感性与P—gp表达程度无关（P〉0．05），与LRP表达的强弱有关（P〈0．05），长春瑞滨、紫杉醇的敏感性均与P—gp和LRP表达的程度有关（P〈0．05），5-氟尿嘧啶与P-gp、LRP的表达程度无关（P〉0．05）。结论采用食管癌体外药敏试验能筛选出对每个患者的敏感药物，指导肿瘤患者的个体化用药，P—gp和LRP表达与部分化疗药物的耐药存在相关性，可为指导临床个体化用药的选择提供依据。

Objective To study the correlation between chemotherapy drug sensitivity and the expression of P- glycoprotein protein （ P- gp） ,lung resistant- related protein （LRP） in different esophageal carcinoma patients, which will offer experimental evidence for clinical individualized chemotherapy of esophageal carcinoma patients. Methods Selected fresh esophageal carcinoma＇s tissue, Common used drugs and chemoscheme for esophageal carcinoma were used for chemosensitivity testing of the primary cultured tumor cells. At the same time,immunohistochemistry method was used to detect the expression of P-gp and LRP of esophageal carcinoma cells. Results The chemotherapy drug sensitivity of single drug was different （ P 〈 0. 05 ）. The combination of Tax and DDP had the best effect. DDP and NVB combination had a better effect than DDP and 5-FU combination. The sensitivity of DDP had no significant correlations with expression intensity of P-gp （ P 〉0. 05） , and it had significant correlation with expression intensity of LRP （ P 〈 0. 05 ）. There were significant correlations between sensitivity of both NVB group and Tax group and expression intensity of P-gp and LRP （ P 〈0. 05）. There was no significant correlations between sensitivity of 5-FU and expression intensity of P-gp and LRP （P 〉 0.05 ）. Conclusion The esophageal carcinoma chemosensitivity in vitro can indicate the sensitive drug of different patients, and guide individualized chemotherapy. The expression of P-gp and LRP has relationship with several chemotherapy drugs, which can provide base for individualized chemotherapy in clinic.