肺癌患者外周血中MDR1的表达及临床意义

Expression and clinical significance of multidrug resistance gene MDR1 in peripheral blood of patients with lung cancer

目的检测多药耐药基因-1(MDR1)在肺癌患者外周血中的表达,探讨MDR1的表达水平与肺癌病理类型及临床化疗进程之间的关系。方法应用荧光定量PCR(qRT-PCR)技术,动态监测45例肺癌患者化疗前后外周血中MDR1的表达水平,并与48例健康者进行对照比较。结果肺癌组化疗前MDR1的阳性率28.89%(13/45),明显高于健康对照组2.08%(1/48),差异显著(P<0.05);各种病理类型的肺癌随着化疗次数的增多MDR1的表达均增强;化疗前后各期MDR1的表达程度:非小细胞肺癌(NSCLC,肺鳞癌和肺腺癌)明显高于小细胞肺癌(SCLC),差异具有统计学意义(P<0.05),而肺鳞癌和肺腺癌之间MDR1的表达程度相当,无显著差异,(P>0.05)。结论化疗可诱导各种病理类型肺癌MDR1表达增加;病理类型不同诱导化疗耐药的机制可能不同:NSCLC可能为原发性MDR,SCLC可能为获得性MDR;动态检测肺癌患者外周血中MDR1的表达水平,有利于进行肺癌耐药的监测与评价。

Objective This study was designed to quantitative analysis of multidrug resistance gene（ MDR1 ） levels in peripheral blood and discuss the impact of MDR1 levels upon pathological types of lung carcinoma and clinical chemotherapy process. Methods Fluorescence quantitative reverse transcription polymerase chain reaction（qRT-PCR） was used to examine the expression of MDR1 levels in peripheral blood of 48 healthy persons and 45 lung cancer cases. Results 13 cases（28.89% ）were positive for MDR1 expression in lung cancers and 1 cases （2.08 % ）in healthy persons before chemotherapy, there was a statistically significant correlation （P 〈 0. 05 ）. The ex- pressing intensity of MDR1 was enhanced by the treat of chemotherapy in pathological types in lung cancer. The expression of MDR1 levels was significantly higher（ P 〈 0. 05 ） in non small cell lung cancer（ NSCLC, Squamous cell carcinoma and adenocarcinoma of lung） than that in small cell lung cancer（ NSCLC ）. While The degree of expression of MDR1 in lung squamous cell carcinoma and adenocarcinoma of the lung is Considerable, （ P 〉 0. 05 ）. Conclusions Chemotherapy may increase the incidece rate of MDRI expression in lung cancer; Differ- ent pathological types of induction chemotherapy resistant mechanism might be different：NSCLC are mainly intrinsic MDR while SCLC is mainly acquired MDR to chemotherapy. The expression level of MDR1 in peripheral blood of patients with dynamic detection of lung cancer is conducive to the monitoring and evaluation of drug resistance in lung cancer.