mdr-1表达与食管癌相关病理因素的研究

THE RELATIONSHIP BETWEEN THE EXPERSSION OF MDR 1 GENE AND PATHOLOGICAL FACTORS IN ESOPHAGEAL CARCINOMA

目的 :探讨食管癌组织中多药耐药基因 (mdr- 1)表达与相关病理因素的关系。方法 :应用反转录聚合酶链反应 (RT- PCR)方法 ,对 78例食管癌及癌旁组织中 m dr- 1表达进行检测。结果 :78例食管癌中 mdr- 1阳性32例 (4 1% ) ,癌旁组织 m dr- 1阳性率 8例 (10 % ) ,癌组织的 mdr- 1阴性与癌旁组织比较具有显著性差异 (P<0 .0 0 1)。m dr- 1表达阳性与肿瘤大小、浸润深度、病理分期及淋巴结转移与否无明显关系 ,但在肿瘤侵犯深肌层或纤维层时的 m dr- 1表达阳性率 (4 5 .8% )明显高于侵犯浅肌层或粘膜层者 (2 6 .3 % ) ,低分化食管癌的 mdr- 1阳性分布显著高于高中分化肿瘤 (P<0 .0 5 )。对术后 1年以上的 42例患者随访发现 ,mdr- 1阳性的肿瘤复发、转移发生率也高于 mdr- 1表达阴性者。结论 :食管癌组织中 m dr- 1基因表达增高 ,mdr- 1的阳性表达不仅表现肿瘤的多药耐药性 ,还可能提示肿瘤的分化不良 。

Objective:To evaluate the expression of mdr 1 gene and its relation with pathological fators of esophageal cancer.Methods:A series of 78 resected tumor tissues from esophageal cancer patients and adjacent normal esophagus tissues were analyzed for mdr 1 gene experssion by RT PCR method.Rusults:The mdr 1 positive rate differed significantly between cancer tissue (41 %) and paracancerous tissue (10 %, P <0.01).Positive expression of mdr 1 gene was not associated with tumor size,infiltration depth,TNM stages and lymphnode metastasis ( P >0.05),but in deep muscularis or fibro membrane invaded by tumor,the mdr 1 positive rates (45.8%) were higher in comparison with invasion shallow muscularis or mucous membrance (26.3 %).The mdr 1 gene expression in undifferentiated tumor was significantly higher than that in well defferentiated ones( P <0.05).The relapse or metastasis rates with mdr 1 positive cases was still higher (44.4 %) than that with mdr 1 negative (29.9 %) by follow up of these patients.Conclusion:In esophageal cancer tissues,positive expression of mdr 1 gene may indicate undifferentiated tumor and be regarded as a poorly prognositic marker.