胃癌多药耐药相关蛋白表达的临床分析

背景：胃癌对化疗药物原发或继发不敏感可致肿瘤多药耐药。目的：探讨胃癌组织中多药耐药相关蛋白P糖蛋白（P-gp）、谷胱甘肽S-转移酶（GST）-xL、Bcl-xL的表达及其意义。方法：收集胃癌手术标本113例，每例标本选取肿瘤组织、距病灶5cm以上的正常胃黏膜组织各1块。以免疫组化法检测多药耐药相关蛋白P-gp、GST-π、Bcl-xL的定位和表达，并与胃癌主要临床病理特征行相关性分析。结果：胃癌组织的P—gp、GST-π、Bcl-xL阳性表达率（48．7％对5．3％，P〈0．05；62馏％对25．7％，P〈0．05；83．2％对23．0％，P〈0．05）和高表达率（18．6％对0％，P〈0．05；23．9％对0％，P〈0．05；71．7％对0％，P〈0．05）均明显高于正常胃黏膜组织，胃癌组织P-gP、GST-π、Bcl-xL二者间表达呈正相关（P〈0．05）。胃癌组织GST-π、Bcl-xL阳性表达与肿瘤组织分化程度呈正相关（P〈0．05）．胃癌组织P-gP、GST-π、Bcl-xL表达与患者的性别、年龄、浸润深度、淋巴结转移和临床分期均不相关（P〉0．05）。结论：胃癌组织多药耐药相关蛋白P-gP、GST-π、Bcl-xL表达与胃癌的发生相关，且肿瘤组织GST-π、Bcl-xL表达与分化程度呈正相关，可作为判断胃癌患者预后的指标．

Clinical Analysis of Expression of Multidrug Resistance-associated Protein in Gastric Carcinoma

Background:The primary or secondary non-sensitivity of gastric cancer to chemotherapy induces multidrug resistance.Aims:To investigate the expressions of multidrug resistance-associated protein P-glycoprotein(P-gp), glutathione S-transferase(GST)-πand Bcl-xL in tissues of gastric cancer and its significance.Methods:Cancerous specimens and normal gastric mucosal specimens(more than 5 cm away from the cancerous lesions)were obtained from 113 samples with gastric cancer.Immunohistochemical staining was used to detect the location and expression of P-gp, GST-πand Bcl-xL,and their relationships with major clinicopathological features of gastric cancer were analyzed. Results:The positive expression rates(48.7%vs.5.3%.P<0.05;62.8%vs.25.7%,P<0.05;83.2%vs.23.0%.P<0.05) and high expression rates(18.6%vs.0%,P<0.05;23.9%vs.0%.P<0.05;71.7%vs.0%,P<0.05)of P-gp,GST-πand Bcl-xL in gastric cancerous tissues were significantly higher than those in normal gastric mucosa.The expressions of P-gp, GST-πand Bcl-xL in cancerous tissues were positively correlated with each other(P<0.05).The expressions of GST-πand Bcl-xL in cancerous tissues were positively correlated with the differentiation of tumor(P<0.05).while no correlations were found between P-gp,GST-πand Bcl-xL expressions and patients’ gender,age,depth of infiltration,lymph node metastasis or clinical stage(P>0.05).Conclusions:The expressions of multidrug resistance-associated protein P-gp,GST-πand Bcl-xL are related with gastric carcinogenesis.The expressions of GST-πand Bcl-xL in cancerous tissues are positively correlated with the differentiation of tumor,and could be used as prognostic factors in patients with gastric cancer.