食管癌多药耐药基因的表达与病理学的关系

Expression of mdr 1 gene in cancer tissuse and its association with morphological indexes of esophageal carcinoma

目的检测食管癌新鲜组织中ｍｄｒ１基因的表达，探讨其与食管癌病理形态学指标间的相互关系。方法对４６例术前未作治疗的食管癌切除标本，用反转录多聚酶链反应技术（ＲＴＰＣＲ）检测ｍｄｒ１基因的表达；并与癌组织分化程度、临床分期（ＴＮＭ）及大体形态学作对比研究。结果全组经病理证实均为鳞癌；ｍｄｒ１基因总表达率为３７％；低、中、高分化者（Ⅰ、Ⅱ、Ⅲ级）表达率分别为３５％（６／１７）、４０％（８／２０）、３３％（３／９）；ＴＮＭ分期表达率为Ⅱａ期３３％（６／１８）、Ⅱｂ期４０％（５／１２）、Ⅲ期３７％（６／１６）；形态学表达率为：溃疡型３３％（３／９）、缩窄型３７％（３／８）、蕈伞型３３％（５／１５）、髓质型４０％（６／１４）。各形态学指标组内差异无显著性意义（Ｐ＞００５）。结论食管癌组织中ｍｄｒ１基因存在先天性表达，且独立于病理形态学之外。提示化疗前要区别对待，对ｍｄｒ１基因表达阳性者应合理选择化疗方案，避免盲目化疗。

Objective To detect the levels of mdr 1 gene expression in fresh untreated esophageal carcinomas, and to correlate these levels to current prognostic indicators of morphology. Methods mdr 1 gene expression of 46 untreated esophageal carcinoma was investigated with reverse transcription polymerase chain reaction (RT PCR), and compared with the positive incidences among differentiated grades, TNM stages and macroscopic types of cancer. Results All 46 samples were pathologically squamous cell carcinoma. The positive incidence of mdr 1 gene expression was 37% (17/46) in the whole group, and 35% (6/17), 40%(8/20),33%(3/9) for differentiated grade Ⅰ,Ⅱand Ⅲrespectively. The expression rate of 33% (6/18), 40% (5/12), and 37% (6/16) was for TNM stage Ⅱ a, Ⅱ b, and Ⅲ respectively. Macroscopically, the positive incidence was 37% (3/8) in constrictive, 33% (5/15) in fungating, 40% (6/14) in medullary, and 33% (3/9) in ulcerative type. There were no significant differences in each category system of morphology. Conclusion Because of highly expressive level of mdr 1 gene in untreated esophageal carcinoma, we should choose appropriate chemotherapeutic regimen for esophageal Ca. The expression of mdr 1 gene in untreated esophageal cancer was independent of morphologic prognostic indexes without correlation between mdr 1 gene expression and morphological indexes.