耐药基因与肺癌药敏的相关性研究

目的 研究耐药基因P-糖蛋白（p-g）、拓扑异构酶Ⅱ（TopoⅡ）表达与肺癌药物敏感试验的相关性及临床应用价值.方法 50例肺癌组织（纤支镜＋手术）纳入研究,耐药基因选用免疫组织化学进行检测,药敏方法采用MTT比色法.结果 （1）P-gp、TopoⅡ在肺癌中阳性表达率分别为：67.5％、50.0％.其两者在鳞癌和腺癌中表达差异无统计学意义（P＞0.05）,但在非小细胞肺癌和小细胞肺癌中,P-gp表达有显著性差异（P＜0.05）.（2）P-gp的表达与化疗药物（顺铂、吉西他滨、长春瑞滨、紫杉醇）的耐药性均呈显著的正相关（P＜0.05）,与异环磷酰胺的耐药性无显著性差异（P＞0.05）;TopoⅡ的表达与顺铂、吉西他滨、紫杉醇、异环磷酰胺的耐药性均呈显著的正相关（P＜0.05）,与长春瑞滨的耐药性无显著性差异（P＞0.05）.结论 P-gp高表达及TopoⅡ的低表达共同介导并可能参与了肺癌耐药机制,且与检测的化疗药物有不同程度的相关性.耐药基因检测可能对指导临床化疗药物的选择具有一定的参考性.

The Relationship Between Resistance Geng and Drug Sensitivity in Lung Cancer

Objective To study the between the expression of drug resistance genes and the rusults of drug sensitivity test. Methods Surgical or Bronchoscopy mirror from 50 patients with lung cancer were measured for drug sensitive by MTT colorimetric method. The drug resistance genes P - gp, Topo Ⅱ were detected by im- munohistochemistry. Result （ 1 ） The expression percentage of P - gp, and Topo H genes in lung cancer were 67.5 %, 50.0 % respectively. There is not significant difference in the expression of P - gp and Topo Ⅱ between human adencarcinoma and sequamous cell carcinoma（P 〉 0.05）, but there is significant difference in the expression of Topo Ⅱ between human adencarcinoma or sequamous carcinoma cell and small cell lung cancer （P 〈 0.05）. （2）The correlation between the positive expression of P - gp in the degrees of chemoresistance to the cisplatin, gemcitabine, vinorelbine and paclitaxel were significantly respectively（P 〈 0.05）, but to the iphspamide drug tolerance is not significant difference（P 〉 0.05 ） ; The positive correlation expression of Topo Ⅱ and the de- grees of chemoresistance to the cisplatin, gemcitabine, paclitaxel and iphspamide were significantly respectively （P〈 0.05）, but to the drug tolerance of vinorelbine is not significant difference（P 〉 0.05）. Conclusion The high expression of P - gp and the low expression of Topo Ⅱ commonly mediate and partipate the lung cancer chems tolerated mechanism, and they have different extent correlation with chemotherapy drug. The detection of genes may be clinically useful in the administration of chemotherapy.