胃癌黏膜活检组织P—gp的检测及意义

THE SIGNIFICANCE OF P-GLYCOPROTEIN EXPRESSION IN GASTRIC CARCINOMA BIOSPY

目的：探讨通过胃粘膜活检组织检测多药耐药基因（MDR1）产物P-gp表达情况来指导化疗的可行性及P－gp在胃癌组织中的表达及意义。方法：免疫组化法检测90例胃癌胃镜活检组织及相应术后切除组织P－gp表达情况。结果：胃镜活检组织P－gp阳性表达率为75.6％，胃癌术后组织P－gp率为66.7%，二者均阳性表达60.0％，均阴性表达17.7％，吻合率77.7％，胃镜活检组织P－gp检测结果与术后切除组织P－gp检测结果无差别（P＞0.05）。P－gp表达与病理类型1分期、分化程度及淋巴结转移状况无关（P>0.05）。结论：通过胃镜活检组织P－gp检测可了解机体耐药,为非手术及术前病人化疗提供依据。此法安全可靠、简便易行。P－gp表达与胃癌生物学行为无关，不宜作为肿瘤恶性度指标，但可作为判断化疗反应的独立预后因素。

Objective:To study the significance of P-glycoprotein (P-gp) and whether it is feasible to guide chemotherapy in gastric carcinoma.Methods:Expression of P-gp was examined by immunohistochemistry in 90 patients with gastric carcinoma through gastroscopy biospy and corresponding gastrectomy.Results:The P-gp was positive in 75.6% of gastroscope biospy and 66.7% of corresponding gastrectomy.The both of them were positive in 60.0% and negative in 17.7%,there was no significant difference in two groups.Expression of P-gp was not related to pathologic pattern,pathologic phase,pathologic histology and the conditions of lymph nodes involved.Conclusion:The examination of P-gp expression is feasible and dependable in presenting the chemotherapy evidence to those patients with no surgical treatment or pro-operative treatment making the examination of P-gp expression in gastric carcinoma biospy.Additionally it is not suitable to be a standard of malignant degree because of its poor correlation with gastric carcinoma biology,but it would be a unique prognosis factor of chemotherapy effection.