胃癌新辅助化疗前后多药耐药基因的表达及其与化疗敏感性的关系

目的 探讨6种多药耐药基因:G谷胱甘肽S转移酶(GST-π)、肺耐药相关蛋白(LRP)、多药耐药相关蛋白(MRP)、拓扑异构酶Ⅱ(Topo Ⅱ)、多药耐药基因蛋白(P-gP)、胸苷酸合成酶(TS)在胃癌新辅助化疗前后的表达及其与化疗敏感性的关系,寻求建立化疗敏感性的预测指标.方法 采用免疫组化方法评价35例胃癌新辅助化疗前后6种多药耐药基因的表达情况,分析各耐药基因表达与化疗疗效的关系.对所有患者均行FOLFOX4方案化疗,以WHO实体瘤疗效评价标准评价疗效.结果 本组35例患者中1例完全缓解(3%),15例部分缓解(43%),16例病情稳定(46%),3例病情进展(9%),新辅助化疗有效率为46%.35例患者肿瘤标本中6种多药耐药基因的表达情况:GST-π阳性率为40%,LRP阳性率为69%,MRP阳性率为34%,TopoⅡ阳性率为37%,P-gp阳性率为86%,TS阳性率为40%.GST-π、LRP、MRP、Topo Ⅱ、P-gP的表达与化疗敏感性无关(P>0.05),TS的表达与化疗敏感性有关(P=0.0048).结论 FOLFOX4方案新辅助化疗不影响6种多药耐药基因GST-π、LRP、MRP、Topo Ⅱ、P-gP及TS的表达;TS的表达与化疗敏感性有关,有可能成为评估胃癌化疗敏感性的重要指标.

Changes of MDR gene expression in patietns of gastric cancer undergoing neoadjuvant chemotherapy

Objective To investigate the expression and sensitivity of 6 muhidmg resistance gene products(MDR) : GST-π、LRP、MRP、Topo Ⅱ、P-gp、TS in gastric cancer during neoadjuvant chemotherapy. Methods Expression of the 6 muhidrug resistance gene was detected by immunohistoehemistry in 35 cases of stomach cancer tissues before and after neoadjuvant chemotherapy. The relationship between muhidrug resistance gene and neoadjuvant chemotherapy was analyzed. All patients were given FOLFOX4, and the effects were evaluated according to World Health Organization criteria. Results The overall response rates to chemotherapy was 46%, expression of the 6 mtdtidrug resistance gene in 35 cases of stomach cancer tissues were as follows:GST-π was 40% ,LRP was 69% ,MRP was 34% ,Topo Ⅱ was 37% ,P-gp was 86%, TS was 40%, expression of the 6 muhidrug resistance gene did not change during neoadjuvant chemotherapy; GST-π、LRP、MRP、Topo Ⅱ、P-gp were not correlated with chemotherapy sensitivity(P > 0.05), while TS was significantly correlated with chemotherapy sensitivity (P = 0.0048). Conclusion FOLFOX4 does not effect a change in the expression of the 6 muhidrug resistance gene: GST-π、LRP、MRP、Topo Ⅱ、P-gp and TS, while TS is significantly correlated with gastric cancer chemotherapy sensitivity.