多药耐药相关基因在胃癌组织中的表达及意义

Expression of Multidrug Resistance-related Genes in Gastric Cancer and its Significance

[目的]研究多药耐药相关基因产物P 糖蛋白(Pgp)、DNA拓朴异构酶Ⅱ(TopoⅡ)在胃癌组织中的表达及其意义。[方法]应用SP免疫组化方法 ,检测两者在101例胃癌及40例胃周阳性转移淋巴结、20例正常胃粘膜、18例异型增生组织中的表达。[结果]正常胃粘膜、异型增生及未经术前化疗的胃癌中Pgp表达强度依次增强 ;化疗导致胃癌Pgp表达增强并与化疗次数有关 ;Pgp表达强度与胃癌浸润深度、淋巴结转移及pTNM分期显著相关 ;Pgp表达水平与胃癌预后有关 ,Pgp高水平表达者预后较差。正常胃粘膜、异型增生及未经化疗的胃癌中TopoⅡ指数(TI)依次增高 ;化疗导致TI下降并与化疗次数有关 ;胃周阳性转移淋巴结中TI较癌原发灶为低。

To investigate the expression of multidrug resistance-related genes production,P-glycoprotein(Pgp)and Topoisomerase Ⅱ (Topo Ⅱ)in gastric cancer and their significance.SP immunohistochemical staining technique was used to study the expression of Pgp and TopoⅡ in surgically resected specimens from 101 cases with gastric cancer,40 positively metastatic lympho nodes,20 normal stomach mucosas and 18 dysplasia.The staining intensity of Pgp in gastric cancer,dysplasia and normal stomach mucosa strengthened orderly.Cases undergoing pre-operative chemotherapy showed a strong expression of Pgp,which was related to the times of chemotherapy.The staining intensity of Pgp was correlated with the depth of tumor invasion,lymph node metastasis and UICC TNM classification.The expression level of Pgp was associated with the prognosis of gastric cancer,cases with higher level expression of Pgp showed poorer prognosis.The labeling index of Topo Ⅱ (TI)for gastric cancer without pre-operative chemotherapy,dysplasia and normal stomach mucosas were in descending order.Pre-operative chemotherapy caused a decrease trend of TI,which was also related to the times of chemotherapy.The TI in positive lympho node was lower than that in primary cancer lesions.[Conclusions]Detection of Pgp and Topo Ⅱ in pre- and post-operative chemotherapy of gastric cancer is helpful to select chemotherapy agents as well as to work out effective clinical treatment schemes for gastric cancer.