多药耐药基因产物表达和细胞凋亡对胃癌影响的研究

Studies of multidrug resistance gene expression and apoptosis in stomach carcinoma

目的 探讨多药耐药 (MDR)基因产物和细胞凋亡指数 (AI)表达与胃癌分型、分期、预后的关系。方法 应用免疫组化及原位末端标记法 (TUNEL) ,对 80例胃癌标本进行MDR指标 (P gp、GST π、TOPOⅡ )及AI检测。结果 P gp表达与临床分期有关 (P <0 .0 5 ) ,正常组织P gp表达高者生存期长 (P <0 .0 5 ) ;GST π表达强度与预后有关 ,高表达者生存期短 (P <0 .0 5 ) ;TOPOⅡ表达与分型有关 (P <0 .0 5 ) ,低分化癌表达高于高中分化癌 ;凋亡指数表达与临床分期有关 (P <0 .0 5 ) ,高表达者其临床分期越晚。结论 MDR与细胞凋亡都属细胞正常基因组表达的一部分 ,在正常组织及癌组织均可有表达。正常组织P gp、GST π的表达与预后有关 ,不同生存期的MDR与细胞凋亡表达差异无显著性 (P >0 .0 5 ) 。

Objective To investigate the influence of multidrug resistance gene (MDR) expression and apoptosis on stomach cancer. Methods A total of 80 cases of paraffin embedded stomach cancer tissues was stained immunohistochemically for P gp, GST π and TOPOⅡ using monoclonal antibodies and apoptosis (in terms of apoptotic index, AI)in tissues was musured by the TUNEL method. The results were correlated with tumor type, clinical stage and prognosis. Results Normal stomach tissue expression of P gp was associated with better survival, but higher level of P gp expression in tumor tissues was associated with poor prognosis. The expression of GST π didnot show a relationship with cell differentiation of stomach cancer and clinical stage of the disease, but positive correlation did exist between intensity of expression and survival time. Although the expression of TOPOⅡ was associated with tumor cell differentiation, it did not affect prognosis. Apoptosis was demonstrated in 73% of the cases and was related to clinical stage of stomach carcinoma. Conclusion While P gp expression in tumor cells is indicative of poor prognosis, its expression in normal tissue has the opposite effect. Positive correlation exits between GST π expression intensity in tumor cells and survival. MDR and apoptosis are related to the biologic behavior of the tumor.