贲门癌和胃远端癌原发灶和淋巴结转移灶的P-糖蛋白表达差异

P-glycoprotein expression in primary lesions and its metastatic lymph nodes with cardia and distal gastric carcinomas

目的：比较p-糖蛋白在贲门癌和胃远端癌原发灶和淋巴结转移灶表达的差异.方法：采用免疫组织化学两步法检测p-糖蛋白在30例贲门癌和16例胃远端癌原发灶、淋巴结转移灶及切缘正常组织中的表达.结果：P-糖蛋白阳性率在贲门癌和胃远端癌的切缘正常组织为16.7％和18.8％,原发灶为40.0％和56.3％,淋巴结转移灶为66.7％和75.0％,贲门癌和胃远端癌的原发灶与转移灶的p-糖蛋白表达均显著高于正常组织;贲门癌转移灶的表达显著高于原发灶,胃远端癌两者的表达差异无统计学意义;贲门癌与胃远端癌三个部位两两比较,差异均无统计学意义.结论：P-糖蛋白参与贲门癌和胃远端癌的原发性多药耐药,贲门癌的原发灶与转移灶间存在p-糖蛋白表达的异质性,胃远端癌不明显.

Objective：To study the expression levels of P-glycoprotein （P-gp） in primary lesions and its metastatic lymph nodes with cardia and distal gastric carcinomas.Methods：Thirty cases of cardia carcinomas and 16 cases of distal gastric carcinomas which included primary lesions,its metastatic lymph nodes and adjacent normal tissues were used to detect the expression levels of P-gp by imrnunohistochemistry.Results：In cardia carcinomas and distal gastric carcinomas,the P-gp positive expression rates of adjacent normal tissues were 16.7％ and 18.8％ respectively,those of primary lesions were 40.0％ and 56.3％,and those of lymph node metastasis lesions were 66.7％ and 75.0％.In cardiac carcinoma and distal gastric carcinoma,the P-gp positive rates of primary lesions and its metastatic lymph nodes were both higher than those of the adjacent normal tissues.In cardiac carcinoma,the expression levels of P-gp in metastatic lymph nodes was higher than those in primary lesions.In distal gastric carcinoma,there was not statistical difference in the expression levels of P-gp between the lymph node metastasis lesions and the primary lesions.There were no statistical significance in the P-gp positive expression rates of primary lesions,its metastatic lymph nodes or adjacent normal tissues between cardia carcinomas and distal gastric carcinomas.Conclusion：P-glycoprotein will be involved in the primary multidrug resistance of cardia carcinoma and distal gastric carcinoma.In cardia carcinoma,there may be heterogeneity of P-glycoprotein expression between lymph node metastasis and primary lesions,but it is not obvious in distal gastric carcinoma.