卵巢癌顺铂耐药性研究进展

卵巢癌顺铂耐药是困扰广大学者的难题，近年来研究发现除细胞内药物蓄积和DNA伤修复以外，基因和凋亡调控因子的变化在其中亦起着重要作用。同时细胞外基质、热休克蛋白等相关因素的发现也为人们提供了新思路。现综述上述领域以及耐药逆转方面的研究成果。     

卵巢癌对顺铂耐药机制的研究进展

卵巢癌的发病率在女性生殖器恶性肿瘤中占第三位，但其患者死亡率却居首位。在细胞减灭术的基础上施以以顺铂为主的联合化疗方案已成为卵巢癌的常规治疗方案。据报道：Ⅲ和Ⅳ期的卵巢癌患者采用联合化疗．其完全缓解率可达60％-80％。但在实际临床应用中却并非如此。近30年来卵巢癌患者的5年生存率一直徘徊于30％-50％之间。其主要原因就是卵巢癌对化疗药物产生了耐爱性。约75％-80％的卵巢上皮癌开始对化疗有反应．其余则表现为原发耐药．最终所有化疗患者至少80％出现耐药。因此，耐药的产生直接影响化疗效果及生存率。如何尽早发现耐药度克服耐药是急需解决的问题。     

Gankyrin基因沉默对人卵巢癌SKOV3/CDDP细胞顺铂耐药性的逆转作用和机制

背景与目的：卵巢癌是常见的妇科肿瘤,抗肿瘤药耐药性的产生是卵巢癌治疗失败的主要原因之一,Gankyrin基因被认为与肿瘤耐药性密切相关,本文探讨了Gankyrin基因沉默对卵巢癌耐顺铂细胞系SKOV3/DDP顺铂耐药性的逆转作用及机制。方法：应用real-time PCR技术考察Gankyrin在SKOV3和SKOV3/DDP细胞中的表达,应用MTS法检测Gankyrin对SKOV3/DDP细胞顺铂耐受性的影响,应用流式细胞术检测肿瘤细胞凋亡和细胞内罗丹明-123(Rhodamine-123,Rh-123)含量的变化,Western blot和real-time PCR技术检测肿瘤细胞耐药相关蛋白MDR1、Caspase-3/8、Survivin和Bcl-2蛋白表达,Western blot法检测p53、NF-κB和PTEN蛋白表达和AKT磷酸化水平。结果：Gankyrin在SKOV3/DDP细胞中表达升高,沉默Gankyrin基因后可增加SKOV3/DDP细胞对顺铂的敏感性。基因沉默前后耐药逆转倍数(resistant factor,RF)为1.81和2.45,肿瘤细胞中Rh-123含量提高了1.73和2.42倍,细胞凋亡率是对照组的2.23倍和4.23倍,耐药相关蛋白MDR1、Survivin和Bcl-2蛋白水平显著下降,MDR1 mRNA表达是对照组的62.8%和21.6%,Survivin mRNA表达是对照组的24.5%和10.3%,Bcl-2 mRNA表达是对照组的47.5%和18.4%,Caspase-3/8、p53和PTEN表达水平上升,AKT磷酸化和NF-κB水平下降。结论：沉默Gankyrin基因可逆转SKOV3/DDP对顺铂的耐药性,可能与抑制药物外排,促进细胞凋亡有关,PTEN/AKT/NF-κB/p53信号通路可能是其中心环节。     

重组ING4基因对卵巢癌OVCAR细胞生长抑制作用的实验研究

目的:观察ING4基因转染人卵巢癌OVCAR细胞后对细胞的生长抑制效应。方法:采用ING4的重组腺病毒载体(Ad-ING4)感染人卵巢癌细胞株OVCAR,用RT-PCR法检测ING4在OVCAR细胞中的表达;MTT法和流式细胞技术检测ING4基因表达对OVCAR细胞的生长抑制和凋亡效应;Western印迹法检测ING4对OVCAR细胞中bax、bcl-2、Ki67表达的影响。结果:在OVCAR细胞中ING4基因的表达对OVCAR细胞增殖有明显抑制作用,并可诱导细胞凋亡;Western印迹法检测结果提示卵巢癌组织中ING4基因表达下降的同时,Ki67表达下调,Bax表达上调,Bcl-2的表达下调。结论:转染ING4基因可抑制OVCAR人卵巢癌细胞的增殖,可通过改变Bax,Bcl-2等凋亡相关基因的表达诱导细胞凋亡。     

hMS H2重组质粒对人卵巢癌细胞顺铂敏感性的影响

目的：研究hMSH2重组质粒对卵巢癌顺铂敏感性方面的影响。方法：构建重组真核表达质粒pCAN－hMSH2,通过酶切及测序法对重组质粒进行鉴定。采用脂质体转染技术对卵巢癌耐药细胞SKOV3／DDP进行瞬时转染,对照组为未转染细胞和SKOV3敏感细胞;hMSH2在细胞内的表达变化由Western blotting和RT－PCR进行检测;四甲基偶氮唑蓝（MTT）法对细胞的顺铂敏感性进行检测;耐药细胞的凋亡情况通过Hoechst染色法检测。结果：重组质粒pCAN－hMSH2转染进SKOV3／DDP后,经RT－PCR和Western blotting检测证实转染成功,hMSH2的表达得到增强;MTT结果提示转染后的卵巢癌耐药细胞对顺铂的敏感性明显增强;Ho-echst染色发现,转染后耐药细胞的凋亡明显增强。结论：hMSH2基因转染后能提高其在SKOV3／DDP细胞中的表达,增强SKOV3／DDP细胞对顺铂的敏感性,促进在顺铂作用下的凋亡。     

上调p38表达提高卵巢癌多细胞球体顺铂敏感性

目的研究p38在卵巢癌多细胞球体化疗耐药中的作用。方法构建p38正义真核表达载体,稳定转染卵巢癌细胞并三维培养形成多细胞球体,RT-PCR及Western blot分析p38表达;CCK-8细胞毒性试验和流式细胞仪检测细胞凋亡率。结果（1）多细胞球体p38表达低于单层细胞。（2）FACS检测转染p38真核表达载体的多细胞球体经顺铂作用后,细胞凋亡率高于转染空载体和未转染的多细胞球体;（3）CCK-8细胞毒性试验示转染p38真核表达载体的多细胞球体相对于转染空载体和未转染的细胞球体对顺铂敏感性更高。结论p38介导顺铂对卵巢癌化疗耐药,上调p38表达,可提高卵巢癌多细胞球体对顺铂的敏感性。     

反义LRP寡核苷酸对卵巢癌多药耐药细胞系OVCAR-3顺铂耐药性的影响

目的:探讨针对肺耐药基因(LRP gene)设计的反义寡核苷酸(AsODN)对人卵巢癌多药耐药细胞系OVCAR-3顺铂(DDP)耐药性的逆转作用.方法:采用罗丹明B(SRB)显色法检测LRP AsODN和DDP细胞毒性作用;采用脂质体(1iplfectamine 2000)介导LRP AsODN转染人卵巢癌多药耐药细胞系OVCAR-3;采用逆转录酶链式反应(RT-PCR)和Westem blot法检测LRP AsODN转染前后OVCAR-3细胞中LRP的表达:采用流式细胞仪测定OVCAR-3细胞在顺铂作用后的凋亡率.结果:LRP AsODN浓度低于800nmol/L时,对OVCAR-3细胞无明显细胞毒作用;LRP AsODN能明显减少OVCAR-3细胞中LRP mRNA和蛋白的表达,增加其顺铂敏感性,且与剂量呈正相关;转染LRP AsODN前后的OVCAR-3细胞在DDP作用后,凋亡率分别为(15.43±1.14)%和(27.43±2.05)%,两者间差异有显著性意义(p=0.001).结论:LRP AsODN能有效阻断OVCAR-3细胞内LRP的表达,恢复细胞对DDP的敏感性.     

维生素C对顺铂杀伤卵巢癌细胞的影响

目的:探讨维生素C 是否能影响顺铂杀伤卵巢癌细胞株OVCAR5、SKOV3、CAOV3,并对其作用机制进行初探。方法:使用梯度浓度维生素C及顺铂处理卵巢癌细胞株,显微镜下观测细胞的形态学变化;使用ATP-TCA方法检测细胞生长抑制情况。选择对维生素C敏感的卵巢癌细胞株。氧化敏感探针DCFH-DA标记细胞 ,检测不同浓度维生素C处理不同时间后细胞内过氧化氢(H2O2 )水平。结果:三株卵巢癌细胞维生素C处理的敏感度不同,但总体呈现出随着维生素C浓度的增加,细胞受到抑制作用增加,维生素C对于顺铂杀伤细胞的作用具有辅助加强效应,该作用呈现剂量依赖效应。其中较低浓度维生素C处理OVCAR5细胞15min各组胞内H2O2 水平相比对照组稍高,当处理浓度为5 000μmol/L时细胞H2O2 水平明显升高,达到164%。培养30min后,荧光强度显示细胞内H2O2 水平比15min时升高更明显。不同浓度组分别达到对照组的94%、106%、122%、188%,培养60min后检测荧光强度发现各给药组H2O2 水平均已低于对照组。12h后检测到细胞内的H2O2 水平处于更低水平,各组均未达到对照组的50%。结论:较高浓度维生素C能增强顺铂杀伤卵巢癌细胞株的能力,并呈现一定的剂量依赖性。该结果可能由于维生素 C通过自氧化机制产生过氧化氢促进卵巢癌细胞凋亡。     

MFG-E8对卵巢癌SKOV3细胞顺铂敏感度的影响及分子机制

目的 探讨沉默MFG-E8基因对SKOV3细胞抗癌药物敏感度的影响及其相关机制.方法 小干扰技术沉默卵巢癌SKOV3细胞中MFG-E8基因并对干扰效率进行测定.CCK-8检测转染MFG-E8 siRNA后SKOV3细胞对顺铂的敏感度.qRT-PCR检测MFG-E8基因沉默后多重耐药蛋白ABCB1及ABCC1 mRNA的...     

Low expression of MYCN promotes cisplatin resistance by suppressing cisplatin-induced apoptosis in epithelial ovarian cancer

Epithelial ovarian cancer (EOC) is the most common cause of gynecological cancer-associated mortality. Cisplatin is one of the most effective chemotherapeutic drugs used in EOC; however, its use can lead to relapse due to cisplatin resistance. MYCN sensitizes neuroblastoma to undergo cisplatin-induced apoptosis. However, to the best of our knowledge, there have been no studies to date on the association between MYCN and cisplatin resistance in EOC. Therefore, the present study assessed this association. Datasets from The Cancer Genome Atlas database were used. The overall survival (OS) of patients receiving platin-based therapy was analyzed using Kaplan-Meier Plotter software. RNA sequencing data of 300 patients with EOC were downloaded from cBioportal. The co-expressed genes were subjected to ‘Kyoto Encyclopedia of Genes and Genomes’ analysis using DAVID software. For gene set enrichment analysis, the expression matrix was separated according to the median expression of MYCN, which was selected for hallmark gene set enrichment. Immunohistochemistry was used to assess MYCN expression in EOC tissue. Western blotting was used to evaluate MYCN, p53, Bax and Bcl-2 protein expression levels in EOC cells. Cell viability and apoptosis were assessed using Cell Counting Kit-8 and flow cytometry, respectively. The results demonstrated that MYCN upregulation was associated with increased cisplatin sensitivity and prolonged OS of patients with EOC and patients receiving platin-based therapy. Cisplatin downregulated MYCN expression in cisplatin-sensitive, but not resistant, EOC cells. The genes co-expressed with MYCN were primarily involved in pathways involved in ‘chemotherapeutic resistance’ and ‘apoptosis’. MYCN enriched the apoptosis and p53 signaling pathways in hallmark gene sets. Cells in which MYCN was knocked down demonstrated significantly increased cisplatin resistance; however, MYCN overexpression in cisplatin-resistant cells restored cisplatin sensitivity. Collectively, the present study demonstrated that MYCN downregulation promoted cisplatin resistance by suppressing cisplatin-induced apoptosis in EOC.     

hMSH2 and GTBP expression in advanced stage epithelial ovarian cancer.

Defects in DNA mismatch repair have been associated with both hereditary and sporadic forms of human cancer. Most of the attention has been focused on the incidence and genetics of mismatch repair defects, while little is known about the expression levels of the mismatch repair proteins and their significance in cancer cell biology. In this study, both the expression levels of hMSH2 and GTBP proteins were investigated by Western blotting in 20 untreated epithelial ovarian cancers. For these analyses, a commercial anti-hMSH2 monoclonal antibody and a newly generated mouse monoclonal anti-GTBP antibody were used. hMSH2 and GTBP proteins were detected by Western blotting in 19 out of 20 (95%) samples analysed and were found to be directly correlated (r= +0.51, P = 0.025). hMSH2 expression was significantly higher in ovarian cancer cells originating from solid tumours than from ascites (H = 4.5, P = 0.033), whereas GTBP content did not significantly differ according to the origin of cancer cells. No statistically significant differences were found in the distribution of hMSH2 and GTBP levels according to the age of the patients, grade of differentiation, histotype and extent of surgical debulking. The amount of hMSH2 protein was demonstrated to be significantly lower in stage IV than in stage III patients (H = 7.35, P = 0.007). Moreover, significantly lower hMSH2 levels were observed in non-responding patients compared to patients who achieved complete or partial response to cisplatin-based chemotherapy (H = 4.88, P = 0.027). Conversely, GTBP levels were not distributed differently according to stage of disease and chemotherapy response. Our study suggests a possible involvement of hMSH2 in ovarian cancer cell biology and susceptibility to chemotherapy. The possible biological and/or clinical role of GTBP expression in ovarian cancer patients remains to be elucidated.     

抑癌基因ING1在大肠癌中的表达及预后意义

目的 探讨ING1基因在散发性大肠癌中的表达与预后及多个临床病理变量之间的关系,并分析其在大肠癌预后的危险因素中是否具有显著意义。方法 应用定量RT-PCR方法检测82例大肠癌手术切除标本及相应的癌旁组织中ING1 mRNA的表达水平,分析其表达的差异,研究其表达水平与大肠癌患者临床病理特征及预后的关系。结果 (1)ING1 mRNA在大肠癌及癌旁组织中均可被检出,同一配对组织相比,癌旁组织中ING1表达量明显高于肿瘤原发灶;(2)ING1 mRNA的表达与大肠癌的浸润层次、淋巴结转移、远处转移以及TNM分期密切相关;(3)肿瘤组织与癌旁组织ING1表达量相比,比值越低其DFS也越低(P＜0.0001);(4)经单因素及多因素COX模型分析后显示,ING1作为候选抑癌基因可作为大肠癌预后的独立预测因素(P＜0.0001)。结论 ING1的过度表达是大肠癌发生过程中的分子事件,可能参与大肠癌的发展过程。ING1可作为判断大肠癌预后的重要分子标志。     

Cisplatin alters nitric oxide synthase levels in human ovarian cancer cells: involvement in p53 regulation and cisplatin resistance

The present study determines if (1) basal protein levels of nitric oxide (NO) synthases (eNOS, iNOS, and nNOS) are different in cisplatin-sensitive (OV2008) and counterpart cisplatin-resistant (C13(*)) human ovarian cancer cells, (2) cisplatin alters NOS levels, (3) NO donor causes apoptosis and p53 upregulation, (4) NO donor sensitizes C13(*) cells to cisplatin via p53 upregulation (determined by p53 siRNA gene-knockdown), and (5) inhibition of endogenous NOS alters cisplatin-induced apoptosis. Basal iNOS levels were higher in OV2008 cells than in C13(*) cells. Cisplatin upregulated iNOS, but dramatically reduced eNOS and nNOS, in OV2008 cells only. Failure of cisplatin to upregulate iNOS and downregulate eNOS/nNOS in cisplatin-resistant C13(*) cells may be an aetiological factor in the development of resistance. The NO donor S-nitroso-N-acetylpenicillamine (SNAP) increased p53 protein levels and induced apoptosis in both cell types, and enhanced cisplatin-induced apoptosis in C13(*) cells in a p53-dependent manner (i.e., enhancement blocked by p53 siRNA). Specific iNOS inhibitor 1400W partially blocked cisplatin-induced apoptosis in OV2008 cells. In cisplatin-resistant C13(*) cells, blocking all NOSs with N(G)-amino-L-arginine dramatically changed these cells from cisplatin-resistant to cisplatin-sensitive, greatly potentiating cisplatin-induced apoptosis. The data suggest important roles for the three NOSs in regulating chemoresistance to cisplatin in ovarian cancer cells.     

生长分化因子15在上皮性卵巢癌中的表达及临床意义

目的:探讨生长分化因子15(growth differentiation factor 15,GDF15)在上皮性卵巢癌组织中的表达及其与临床病理因素的相关性.同时探讨上皮性卵巢癌患者血清GDF15水平及其对诊断的意义.方法:应用免疫组织化学、酶联免疫吸附试验检测92例上皮性卵巢癌患者组织及血清中GDF15表达水平.结果:上皮性卵巢癌患者组织GDF15的表达强度显著高于正常卵巢组织,且与患者手术分期、病理分级、有无腹水及淋巴结转移相关.上皮性卵巢癌患者血清GDF15水平(1 307.72±352.99)pg/ml显著高于正常对照组(405.88±75.67)pg/ml(P<0.05).结论:GDF15表达水平与上皮性卵巢癌发生发展密切相关,对于卵巢癌患者诊断及预后预测具有一定的指导意义.     

The E3 ubiquitin ligase EDD is an adverse prognostic factor for serous epithelial ovarian cancer and modulates cisplatin resistance in vitro

Despite a high initial response rate to first-line platinum/paclitaxel chemotherapy, most women with epithelial ovarian cancer relapse with recurrent disease that becomes refractory to further cytotoxic treatment. We have previously shown that the E3 ubiquitin ligase, EDD, a regulator of DNA damage responses, is amplified and overexpressed in serous ovarian carcinoma. Given that DNA damage pathways are linked to platinum resistance, the aim of this study was to determine if EDD expression was associated with disease recurrence and platinum sensitivity in serous ovarian cancer. High nuclear EDD expression, as determined by immunohistochemistry in a cohort of 151 women with serous ovarian carcinoma, was associated with an approximately two-fold increased risk of disease recurrence and death in patients who initially responded to first-line chemotherapy, independently of disease stage and suboptimal debulking. Although EDD expression was not directly correlated with relative cisplatin sensitivity of ovarian cancer cell lines, sensitivity to cisplatin was partially restored in platinum-resistant A2780-cp70 ovarian cancer cells following siRNA-mediated knockdown of EDD expression. These results identify EDD as a new independent prognostic marker for outcome in serous ovarian cancer, and suggest that pathways involving EDD, including DNA damage responses, may represent new therapeutic targets for chemoresistant ovarian cancer.     

上皮性卵巢癌组织中环氧化酶-2的表达与化疗耐药的相关性研究

目的:探讨上皮性卵巢癌组织中环氧化酶-2(cyclooxygenase-2,COX-2)表达与化疗耐药的关系,以及与p53表达的相关性。方法:用免疫组化SP法检测108例上皮性卵巢癌组织和20例正常卵巢组织中COX-2和p53表达。结果:COX-2和p53在上皮性卵巢癌组织中阳性表达率分别为48.1%和59.3%,正常卵巢组织均未见表达,差异有极显著性(P<0.01);COX-2和p53表达呈显著正相关(P<0.01)。COX-2表达与患者病理类型、临床分期、病理分级及年龄无关,与术后残留灶直径有显著相关性(P<0.01)。COX-2和p53阳性表达率,耐药组和非耐药组相比均有显著差别(P<0.01)。多因素分析显示,卵巢癌患者COX-2、p53表达和术后残留灶直径是与化疗耐药密切相关的独立因素。结论:COX-2表达是与化疗耐药相关的独立危险因素。COX-2过表达与抑癌基因p53的突变可能具有相互促进作用,在卵巢癌化疗耐药中起重要作用。