多药耐药基因产物在大肠癌组织中的表达及临床意义

Clinical signifi cance of the expression of multidrug resistance gene products in colorectal carcinoma

目的:探讨大肠癌组织中多药耐药基因产物的表达特点及其对大肠癌化疗的指导意义.方法:随机选取2007-05/2009-05空军总医院普通外科行根治性手术的大肠癌患者56例组成试验组,选取在消化内科门诊健康体检行肠镜活检患者10例组成对照组.应用免疫组织化学法检测两组标本中GST-π、P-gp、Topo-Ⅱ、TS和MRP的表达,并结合其临床病理资料进行回顾性分析.结果:GST-π、P-gp、Topo-Ⅱ、TS和MRP在实验组和对照组间的表达差异显著(P<0.01或<0.05),GST-π、P-gp、Topo-Ⅱ、TS和MRP在大肠癌中的阳性表达率依次为73.2%(41/56)、66.1%(37/56)、48.2%(27/56)、41.1%(23/56)和37.5%(21/56).他们的表达与性别、年龄、肿瘤部位、大小、侵袭深度和转移与否均无关,而与肿瘤的分化程度和组织学类型密切相关.结论:GST-π、P-gp、Topo-Ⅱ、TS和MRP在大肠癌表达存在明显的异质性,其高表达是大肠癌多药耐药产生的基础.

AIM： To detect the expression of multidrug resistance gene product in colorectal carcinoma （CRC） and analyze their significance in the chemotherapy for CRC. METHODS： Fifty-six CRC patients who under- went radical surgery from May 2007 to May 2009 at our hospital were randomly selected. Ten healthy subjects who underwent colonoscopy and biopsy were randomly selected as controls. The streptavidin-peroxidase （SP） immunohis- tochemistry was used to detect the expression of GST-π, P-gp, Topo-II, TS and MRP in CRC tissues and normal mucosal tissues. The clinico- pathological data of the patients were analysed retrospectively. RESULTS： The expression of GST-π, P-gp, Topo-II, TS and MRP proteins showed signifi- cant differences between CRC patients and con- trol patients （all P 〈 0.01 or 0.05）. The positive expression rates of GST-π, P-gp, Topo-II, TS and MRP proteins in CRC were 73.2% （41/56）, 66.1% （37/56）, 48.2% （27/56）, 41.1% （23/56） and 37.5% （21/56）, respectively. The positive expression rates of these proteins were closely correlated with histological type and degree of differentia- tion, but not correlated with patient sex, age, tu- mors site, tumor size, invasive depth and lymph node metastasis. CONCLUSION： The expression of GST-π, P-gp, Topo-II, TS and MRP proteins in CRC shows obvious heterogeneity. The overexpression of these protein underlies the multidrug resistance in CRC.