子宫颈癌患者新辅助化疗前后癌组织中mdr1、肺耐药蛋白mRNA及其蛋白的表达变化和意义

Expression and significance of mdrl and lung resistance protein mRNA in cervical carcinoma before and after neoadjuvant chemotherapy.

目的寻找预测子宫颈癌新辅助化疗效果的分子生物学指标。方法采用real time RT—PCR和免疫组织化学法检测40例子宫颈癌患者新辅助化疗前后癌组织中mdr1、肺耐药蛋白（LRP）mRNA及其编码蛋白P-gP、LRP表达水平。结果新辅助化疗前后子宫颈癌组织中mdr1的表达量分别为（45．800±0．636、62．381±0．743，t=-66．582，P〈0．01）；新辅助化疗前后子宫颈癌组织中LRP mRNA的表达量分别为（50．048±0．770、66．912±0．752，t=-78．604，P〈0．01）；新辅助化疗前后子宫颈癌组织中P-gP的阳性表达分别为40．0％（16／40）、70．0％（28／40），x^2=7．273，P=0．007；新辅助化疗前后子宫颈癌组织中LRP的阳性表达分别为62．5％（25／40）、92．5％（37／40），x^2=10．323，P=0．001，新辅助化疗后mdr1、LRPmRNA及其编码蛋白P-gP、LRP表达水平较化疗前明显升高，2组比较差异有统计学意义（P〈0．01）。P-gP、LRP表达与患者年龄、肿瘤大小、临床分期、病理分级无关（P〉0．05）；P-gP蛋白的阳性与阴性患者其化疗有效率分别为6（37．5％）、17（70．8％），2组比较差异有统计学意义（x^2=4．365，P〈0．05）。LRP蛋白的阳性与阴性患者其化疗有效率分别为12（48．0％）、13（86．7％），2组比较差异有统计学意义（x^2=5．980，P〈0．05）；P-gP与LRP成正相关（x^2=4．177，r=0．323，P〈0．05）。结论P-gP、LRP表达状态有可能作为预测化疗效果的参考指标。

Objective To explore the biological parameter predicting the effect of neoadjuvant chemotherapy in cervieal carcinoma. Methods The expressions of the P-glueoprotein （P-gp） and lung resistance protein （LRP） as well mdrl and LRP mRNA were examined by real time RT-PCR and immunohistochemical assay in 40 specimens of cervical carcinoma before and after neoadjuvant ehemotherapy. Results The expression level of mdrl was [ （45. 800 ± 0.636 ） vs （62.381 ± 0.743 ）, t = - 66. 582, P 〈 0.01 ], the expression level of LRP mRNA was [ 50.048 ± 0.770,66. 912 ± 0.752, t = - 78. 604, P 〈 0.01 ] before and after neoadjuvant chemotherapy The positive expression of P-gp was[ 40.0% （16 /40）,70.0% （28/40）, x^2 = 7. 273, P = 0. 007 ] and that of LRP was [62.5% （25/40） ,92.5% （37/40） ,x^2 = 10.323 ,P =0.001 ] ,which were significantly higher than that before neoadjuvant chemotherapy （ P 〈 0.01 ） ; the expressions of P-gp and LRP were irrelated to age, tumor size, TNM stage and pathology grade（P 〉 0.05 ） ; the effeetive rate of chemotherapy was 6 （ 37.5% ） in P-gp positive patients and 17 （70.8%）in P-gp negative patients （ x^2 = 4. 365, P 〈 0.05 ）, while the effective rate of chemotherapy was 12 （48.0%） in LRP positive patients and 13 （ 86.7 % ） in LRP negative patients （ x^2 = 5. 980, P 〈 0.05 ）. The expression of P-gp was positively correlated with the expressions of LRP （ x^2 = 4. 177, r = 0.323,P 〈 0.05 ）. Conclusion The P-gp and LRP expression status can be used as a biological parameter to predict the effect of neoadjuvant chemotherapy.