喉癌组织多药耐药表型与肿瘤化疗反应的关系

The correlation of multidrug resistance phenotype with clinical response to chemotherapy in laryngeal cancer

目的 :观察喉癌患者多药耐药表型与肿瘤化疗反应的关系。方法 :对 3 6例喉癌患者 ,于诱导化疗前取癌组织标本 ,采用免疫组化法检测 P-糖蛋白 ( P- gp)。患者均接受以顺铂、5 -氟尿嘧啶和平阳霉素为方案的术前诱导化疗 ,肿瘤对化疗反应的评估分为有效 (包括完全反应或部分反应 )或无效 (包括稳定或恶化 )。结果 :3 6例中P- gp阳性 12例 ( 3 3 .3 % ) ,P- gp阴性 2 4例 ( 66.7% )。 12例 P- gp阳性患者对化疗反应有效 3例 ( 2 5 % ) ,无效 9例( 75 % ) ;2 4例 P- gp阴性患者对化疗反应有效 2 1例 ( 87.5 % ) ,无效 3例 ( 12 .5 % ) ,P- gp阳性者化疗有效率明显低于 P- gp阴性者 ( P <0 .0 5 )。结论 :本文资料显示 ,以 P- gp介导的多药耐药表型与喉癌对化疗耐药性之间存在统计学意义。

Objective:The correlation of multidrug resistance(MDR) phenotype with clinical response to chemotherapy was investigated in patients with laryngeal cancer.Method:Tumor specimens prior to neoadjuvant chemotherapy from 36 cases of laryngeal cancer were collected for detection of P glycoprotein(P gp)with anti Pgp monoclonal antibodies(JSB I).Immunohistochemical assays were used for P gp detection on 5 μm thick frozen section.Anti Pgp monoclonal antibodies(JSB I)as primary antibodies and goat anti mouse IgG monoclonal antibodies as second antibodies were applied.All patients received preoperative induction chemotherapy with a regimen of cisplatin,5 fluorouracil and pingyangmycin.Evaluation for tumor response was scored as follows:Response to chemotherapy was graded as good for complete response or partial response;as poor for stable disease or progressive disease.Result:Of the 36 pretreatment specimens,12( 33.3 %)were P gp positive and 24( 66.7 %)were P gp negative.Among the 12 patients with P gp positive,3(25%)had a good response and 9(75%)had a poor response.Of the 24 patients with P gp negative,21( 87.5 %) had a good response and 3( 12.5 %) had a poor response (P< 0.05 ).Conclusion:These preliminary data suggest that a significant correlation between MDR phenotype,Pgp mediated and chemotherapy resistance existed.