介入治疗对耐药基因在原发性肺癌表达的影响

The effect of interventional treatment on the expression of drug-resistance gene in primary lung carcinomas

目的 探讨介入治疗对耐药基因在原发性肺癌表达的影响。方法 通过支气管镜和手术获得未行化疗和进行过介入治疗的肺癌标本共 118例。小细胞癌 (SCLC) 2 6例 ,非小细胞癌(NSCLC) 92例 (鳞癌 4 8例 ,腺癌 4 4例 ) ;其中 ,非化疗组 5 0例 ;单纯行支气管动脉灌注化疗药物的非栓塞组 2 8例 ;应用碘油抗癌药乳剂栓塞支气管动脉的栓塞组 4 0例。运用免疫组织化学两步法检测各组标本中的鼠抗人P 糖蛋白 (PgP)和谷胱甘肽硫转移酶 π(GST π)的阳性率。结果 非化疗组的PgP与GST π的阳性率分别为 32 0 %与 34 0 % ,非栓塞组分别为 75 0 %与 78 6 % ;栓塞组则分别为 5 0 0 %与 5 2 5 %。非化疗组与非栓塞组的PgP与GST π阳性率差异均有非常显著性意义 (P <0 0 1)。非化疗组与栓塞组的PgP与GST π阳性率差异均无显著性意义 (P >0 0 5 )。在NSCLC中分化程度高的I级癌细胞的耐药基因的表达高于分化程度低的Ⅱ、Ⅲ级癌细胞 (P值均 <0 0 1)。结论 检测癌组织中的PgP与GST π对肺癌化疗的个体化方案制定有重要的指导意义 ,支气管动脉灌注化疗可使肺癌多药耐药性的阳性表达率增高 。

Objective To study the effect of interventional treatment on the expression of PgP and GST π in different histopathological types of primary lung carcinoma. Methods One hundred and eighteen cases of histopathologically verified primary lung carcinoma were studied. SCLC was found in 26 cases and NSCLC in 92 cases. The non chemotherapy group had 50 cases, and the interventional treatment group had 68 cases. PgP and GST π were examined in all specimens with 2 step immunohistochemistry. Results The positive expression rates of PgP and GST π were 32.0% and 34.0% in non chemotherapy group, respectively, 75.0% and 78.6% in interventional treatment with non embolization group, respectively, and 50.0% and 52.5% in interventional treatment with embolization group, respectively. The positive expression rates of PgP and GST π had significant difference between non chemotherapy group and interventional treatment with non embolization group( P <0.01), and there was no significant difference between the non chemotherapy group and the interventional treatment with embolization group( P >0.05). There was a tendency of positive correlation between differentiated degree of carcinoma and the expression of PgP and GST π in NSCLC. Condusion To detect PgP and GST π in carcinoma tissue is important and has the instructive significance for chemotherapy of lung carcinoma. The positive rate of multidrug resistant gene is obviously increased in the primary lung carcinoma with bronchial arterial chemotherapy. The inducement to multidrug resistance gene in bronchial arterial embolization with the emulsifying agent of oil anticarcinogen was lower.