正常宫颈、CIN、宫颈鳞癌中P-gp、MRP1、Survivin的相关表达及对新辅助化疗作用的研究

The Expression of P-gp,MRP1,Survivin in Normal Cervical Epithelia,CIN,Cervical Squamous Cell Carcinoma and the Research of the eEffect on NACT

目的:探讨正常宫颈、CIN及宫颈鳞癌组织中P-gp、MRP1、Survivin三种耐药蛋白的相关表达,以及三种耐药蛋白与宫颈鳞癌新辅助化疗的关系。方法:采用免疫组织化学SP法和自动图像分析系统检测三种耐药相关蛋白P-gp、MRP1、Survivin在15例正常宫颈组织、15例CIN以及30例Ⅰb2-Ⅱa期宫颈鳞癌患者新辅助化疗前后中的表达。结果:从正常宫颈组织到CIN再到宫颈鳞癌,P-gp、MRP1、Survivin的阳性表达量显著升高(P<0.01);新辅助化疗有效组P-gp和Survivin阳性表达量显著低于新辅助化疗无效组(P<0.01),且化疗后P-gp的阳性表达量显著高于化疗前水平(P<0.01),Survivin的阳性表达量低于化疗前水平(P<0.05);新辅助化疗有效组MRP1表达量虽然低于无效组,但是差异无统计学意义(P>0.05),且化疗前后的阳性表达量亦无统计学意义(P>0.05)。结论:宫颈鳞癌组织中存在多种耐药相关蛋白的共同表达,联合检测多个耐药相关蛋白,可以在一定程度上更好地指导临床化学用药,选择有效的个体化治疗方案。

Objective:To investigate the expression of P-gp,MRP1 and survivin in normal cervical epithelia,CIN and cervical squamous cell carcinoma,and the relationship between them and Neoadjuvant chemotherapy(NACT).Methods:The expression of P-gp,MRP1 and survivin were determined by immunohistochemical S-P method and colour pathological image computer analysis system,in 15 cases of normal cervical epithelia,15 cases of CIN and 30 cases of invasive squamous cell cervical carcinoma in stageⅠb2-ⅡA before and after NACT.Results:It was found that the positive level of P-gp,MRP1 and survivin expression increased in the order of normal cervical epithelium,CIN and invasive squamous cell carcinoma of cervix(P<0.01).The positive level of P-gp and survivin in the effective group was significantly lower than that in the invalid group(P<0.01),and the expression of P-gp after NACT is significantly higher than before(P<0.01),the expression of survivin after NACT is significantly lower than before(P<0.01).There was no correlation of the positive level of MRP1 between the effective and invalid group after NACT(P>0.05),and there was also no correlation of the expression of MRP1 before and after NACT(P>0.05).Conclusion:Multiple drug resistance proteins are expressed in cervical squamous cell carcinoma,combined detection of them can better guide clinical medication and select individualized treatment options.