凋亡相关基因和半胱天冬氨酸蛋白酶-3在卵巢癌顺铂耐药细胞株中的表达

目的　探讨凋亡相关基因和半胱天冬氨酸蛋白酶 3 (caspase 3 )在卵巢癌顺铂 (DDP)耐药细胞株中的表达。方法　采用逆转录聚合酶链反应 (RT PCR)技术、蛋白印迹法和流式细胞仪分析卵巢癌DDP敏感细胞株A2 780、COC1和DDP耐药细胞株A2 780 /DDP、COC1/DDP中凋亡相关基因bcl 2、bcl XL、bax和bcl Xs的表达 ,及不同浓度DDP(0、5、10、2 0 μmol/L)作用后上述 4种细胞中caspase 3活性及其底物多聚腺苷二磷酸核糖聚合酶 (PARP)的变化。结果　bcl 2和bcl XLmRNA的表达 ,A2 780 /DDP细胞分别为 1 87± 0 2 5和 1 73± 0 15 ,明显高于A2 780细胞的 1 48± 0 14和 1 41± 0 19,差异有显著性 (P <0 0 5 ) ;bcl 2和bcl XL 蛋白的表达 ,A2 780 /DDP细胞分别为 1 99± 0 11和 1 69± 0 16,明显高于A2 780细胞的 1 5 1± 0 17和 1 2 8± 0 11,差异有显著性 (P <0 0 5 ) ;bcl 2和bcl XL在COC1/DDP细胞中的表达明显高于COC1细胞 ,差异有显著性 (P <0 0 5 ) ;bax的表达 ,A2 780 /DDP与A2 780、COC1/DDP与COC1细胞分别比较 ,差异均无显著性 (P >0 0 5 ) ;在上述 4种细胞中均未检测到bcl Xs的表达。不同浓度DDP作用后 ,A2 780 /DDP和COC1/DDP细胞中caspase 3活性明显低于A2 780和COC1细胞 (P <0 0 5 ) ;其凋亡率     

卵巢上皮性癌细胞系铂类药物耐药相关蛋白的比较蛋白质组分析

目的 对卵巢上皮性癌（卵巢癌）细胞系进行铂类药物耐药相关蛋白的比较蛋白质组分析.方法 应用双向凝胶电泳和基质辅助激光解吸电离飞行时间质谱（MALDI-TOF-MS）寻找对铂类药物敏感（SKOV3和A2780）及耐药（SKOV3/CDDP、SKOV3/CBP、A2780/CDDP和A2780/CBP）卵巢癌细胞系的差异表达蛋白质.RT-PCR、蛋白印迹法分别验证差异表达蛋白质在各细胞系中mRNA和蛋白的表达水平.结果 共发现5种蛋白质（膜联蛋白A3、破解蛋白、辅酶Ⅱ依赖的异柠檬酸脱氢酶1、谷胱甘肽转移酶omega 1和丝切蛋白1）在3种及3种以上耐药细胞中均有差异表达,膜联蛋白A3的表达差异最显著.膜联蛋白A3基因的mRNA和蛋白表达水平,SKOV3/CDDP、SKOV3/CBP、A2780/CDDP和A2780/CBP细胞较SKOV3和A2780细胞明显升高.结论 应用蛋白质组学技术对SKOV3和A2780细胞系及其4种耐药细胞系进行比较蛋白质组分析,共识别鉴定出5种蛋白质,膜联蛋白A3、破解蛋白、辅酶Ⅱ依赖的异柠檬酸脱氢酶1、谷胱甘肽转移酶omega 1和丝切蛋白1可能参与卵巢癌铂类药物耐药机制的形成.     

微小RNA-16逆转上皮性卵巢癌顺铂耐药的研究

目的:研究微小RNA-16(miR-16)在人上皮性卵巢癌顺铂耐药细胞中的表达及其与顺铂耐药的关系。方法:脂质体lipofectamine2000介导miR-16成熟体模拟物(mimics)及阴性对照片段(NC)分别转染人卵巢癌顺铂耐药细胞株SKOV3/DDP。实时荧光定量PCR检测各组细胞中miR-16的表达;蛋白印迹法检测细胞中Bcl-2蛋白、c-myc蛋白的表达;四甲基偶氮唑蓝(MTT)比色法检测细胞的顺铂半数抑制浓度(IC50);caspase-3活性检测试剂盒检测细胞内caspase-3酶的活性;流式细胞仪检测细胞的凋亡率。结果:(1)SKOV3/DDP细胞顺铂耐药指数(RI)为5.33;(2)SKOV3/DDP细胞中miR-16表达水平明显低于SKOV3细胞,约为后者的1/10(P=0.000),转染miR-16 mimics后SKOV3/DDP细胞中miR-16水平升高约660倍(P=0.001);(3)SKOV3/DDP细胞Bcl-2、c-myc蛋白的相对表达量较SKOV3细胞明显升高,转染miR-16 mimics后SKOV3/DDP细胞Bcl-2、c-myc蛋白的相对表达量明显降低(P<0.01);(4)SKOV3/DDP细胞转染miR-16 mim-ics后,顺铂IC50(14.19±0.06)较转染NC组(22.52±0.60)明显降低(P=0.002),且顺铂作用后caspase-3的酶活力单位也明显升高(P=0.000);(5)顺铂(20μg/ml)作用24h、48h后,SKOV3组凋亡率明显高于SKOV3/DDP组,转染miR-16 mimics的SKOV3/DDP细胞凋亡率约为转染NC细胞的1.5倍(P<0.01)。结论:miR-16可能通过靶向下调上皮性卵巢癌细胞Bcl-2蛋白,并协同调节c-myc蛋白的表达,增强卵巢癌顺铂耐药细胞对顺铂诱导凋亡的敏感性,发挥逆转耐药的作用。     

谷胱甘肽-S-转移酶P1启动子调控的胞嘧啶脱氨酶和尿嘧啶磷酸核糖转移酶融合基因对卵巢癌顺铂耐药细胞的体外杀伤作用

目的　观察谷胱甘肽 S 转移酶P1(GSTP1)启动子调控的胞嘧啶脱氨酶和尿嘧啶磷酸核糖转移酶融合基因 (CD UPP ,即自杀基因 )表达的腺病毒载体 ,对卵巢癌顺铂耐药细胞的体外杀伤作用。方法　采用细菌内同源重组法构建腺病毒载体 ,设立卵巢癌顺铂敏感细胞株A2 780和以其诱导的耐药细胞株A2 780 /DDP ,在体外用重组腺病毒转染两组细胞并联合应用前药 5 氟胞嘧啶 (5 FC) ,观察两组卵巢癌细胞对 5 FC的敏感性。将CD UPP阳性和CK UPP阴性的A2 780 /DDP细胞按不同比例混合后给予 5 FC ,观察 5 FC对混合细胞的杀伤作用。结果　当重组腺病毒滴度为 10 0感染复数(MOI)、5 FC浓度为 2 5 0 μg/ml时 ,对顺铂耐药的A2 780 /DDP细胞的存活率为 (3 6± 1 0 ) % ,对顺铂敏感的A2 780细胞的存活率为 (76 5± 2 8) % ,两者比较 ,差异有显著性 (P <0 0 5 )。此外 ,2 0 ? UPP阳性A2 780 /DDP细胞 ,即可引起 80 3%的混合细胞死亡 ,CD UPP / 5 FC系统表现出明显的旁观者效应。结论　由腺病毒介导的含有GSTP1调控的CD UPP/ 5 FC系统 ,对卵巢癌顺铂耐药细胞具有特异性杀伤作用 ,为临床上克服卵巢癌化疗耐药 ,提供了一条安全、高效的治疗途径。     

CTHRC1对卵巢癌细胞顺铂耐药的作用及机制研究

目的:探究胶原三股螺旋重复蛋白1(CTHRC1)对卵巢癌细胞顺铂耐药的作用及其相关机制。方法:Western blot法检测卵巢癌细胞株A2780、SKOV3及顺铂耐药细胞株A2780/DDP、SKOV3/DDP中CTHRC1蛋白表达水平。慢病毒lenti-sh CTHRC1转染SKOV3/DDP细胞,下调CTHRC1表达水平。CCK-8法检测沉默CTHRC1后SKOV3/DDP细胞增殖情况及顺铂半数抑制浓度(IC_(50))的变化。Western blot法检测转染后SKOV3/DDP细胞中抗凋亡蛋白Bcl-2的表达情况及Akt、STAT3的磷酸化水平。结果:与A2780和SKOV3细胞相比,顺铂耐药细胞株A2780/DDP和SKOV3/DDP细胞中CTHRC1蛋白表达水平相对较高(P0.05)。靶向下调CTHRC1表达后,SKOV3/DDP-sh CTHRC1细胞的增殖能力无明显变化,但顺铂的IC_(50)显著降低(P0.01),Akt、STAT3磷酸化水平受到抑制,Bcl-2表达水平降低(P0.05)。结论:CTHRC1可能通过Akt、STAT3信号通路,调节抗凋亡蛋白Bcl-2的表达,继而影响卵巢癌细胞对顺铂的敏感度。     

IDO与卡铂诱导卵巢癌耐药的免疫学研究

目的:通过卡铂诱导卵巢癌耐药的细胞系对免疫细胞功能影响的研究,从免疫学角度探讨耐药卵巢癌转移或复发的机制。方法:建立卵巢癌SKOV3细胞对卡铂耐药的细胞系SKOV3/CBP,ELISA法检测SKOV3和SKOV3/CBP细胞吲哚2,3双加氧酶(IDO)表达;将两组细胞分别与淋巴细胞、NK细胞及C8~+T细胞培养,MTT法检测淋巴细胞的增殖能力、LDH检测NK细胞的杀伤能力及ELISPOT检测C8~+T细胞的杀伤能力。结果:与SKOV3细胞株相比,耐药细胞株SKOV3/CBP内IDO表达明显增强(P0.05),且与其共培养的淋巴细胞的增殖能力、NK细胞的杀伤能力及CD8+T细胞的杀伤能力较SKOV3组降低,差异有统计学意义(P0.05)。结论:卡铂耐药SKOV3细胞内IDO表达增加,其可通过降低免疫细胞作用的敏感性而发生免疫逃逸促进耐药肿瘤的转移和复发,IDO可作为卵巢癌卡铂耐药治疗新的靶点。     

RNA干扰技术抑制卵巢上皮性癌耐药细胞Topo Ⅱα基因表达并逆转耐药的体外研究

目的 探讨RNA干扰技术抑制卵巢上皮性癌(卵巢癌)耐药细胞TopoⅡα基因的表达是否能逆转耐药.方法 (1)设计并筛选针对Topo Ⅱα基因的、沉默效果最佳的小分子干扰RNA(siRNA),将其克隆到psilencer4.1-CMV-neo载体上;将psilencer4.1-CMV-neo-Tope Ⅱα重组质粒转染至受试细胞,建立稳定转染重组质粒的细胞Topo Ⅱα siRNA(+)SKOV3/DDP.(2)采用RT-PCR技术和蛋白印迹法测定稳定转染细胞中TopoⅡαmRNA和蛋白的表达;分别采用四甲基偶氮唑蓝比色法、流式细胞仪和高效液相色谱法测定TopeⅡαRNA干扰前后细胞的耐药指数、细胞周期和细胞内顺铂含量的变化.结果 (1)转染psilencer4.1-CMV-neo-Topo Ⅱα质粒后能抑制SKOV3/DDP细胞中TopoⅡα基因的表达,TopeⅡα siRNA(+)SKOV3/DDP和SKOV3/DDP细胞中TopoⅡα mRNA的表达水平分别为0和0.92±0.08;两种细胞中TopoⅡα蛋白的表达水平分别为0.51±0.04和1.95±0.09,两者比较,差异有统计学意义(P<0.01).(2)SKOV3/DDP细胞转染Topo Ⅱα siRNA后耐药指数下降,TopoⅡα siRNA(+)SKOV3/DDP和SKOV3/DDP细胞的耐药指数分别为3.46和5.05,两者比较,差异有统计学意义(P<0.05).(3)TopoⅡα siRNA(+)SKOV3/DDP细胞的G_0/G_1期、G_2/M期细胞比例较SKOV3/DDP细胞增加,S期细胞比例减少(P均<0.05).(4)Topo Ⅱα siRNA(+)SKOV3/DDP细胞经20 μg/ml顺铂处理24 h后,其顺铂含量(157.20 ng)较SKOV3/DDP细胞(63.99 ng)升高,两者比较,差异有统计学意义(P<0.05).结论 阻断卵巢癌耐顺铂细胞中Topo Ⅱα基因的表达能逆转其对顺铂的耐受性.     

ERCC1基因与卵巢上皮癌细胞铂类耐药相关性探讨

目的 检测切除修复交叉互补1（ERCC1）基因在人卵巢上皮癌顺铂(DDP)耐药细胞株SKOV3／DDP及其亲本细胞株SKOV3中的表达,探讨ERCC1基因在卵巢上皮癌顺铂耐药中的意义以及有效沉默ERCC1基因能否有效逆转SKOV3／DDP细胞对DDP耐药。方法 于2013-2014年在南方医科大学采用实时荧光定量PCR(RT-PCR)和Western印迹法检测 ERCC1 mRNA和蛋白在SKOV3／DDP及SKOV3细胞中的表达。人工构建3个靶向沉默ERCC1基因的短发夹状RNA(shRNA)质粒表达载体,慢病毒载体法转染至SKOV3／DDP细胞,RT-PCR和Western印迹法检测ERCC1基因水平并挑选沉默效果最佳的表达载体。RT-PCR和Western印迹法检测稳定转染后SKOV3／DDP细胞中ERCC1基因的表达,CCK-8法检测转染细胞对DDP的耐药性。结果 SKOV3／DDP细胞中ERCC1 mRNA和蛋白的表达量明显高于SKOV3,差异有统计学意义(P<0.01)。稳定转染ERCC1 shRNA后的SKOV3／DDP细胞,ERCC1的mRNA及蛋白的表达量明显下降,差异有统计学意义(P<0.01)。细胞活性检测提示特异性沉默ERCC1基因能增加SKOV3/DDP 细胞对顺铂的敏感性(P<0.05)。结论 ERCC1基因在SKOV3／DDP细胞中的表达明显升高,有效沉默ERCC1 基因能有效逆转SKOV3/DDP细胞对DDP耐药,增加卵巢上皮癌DDP耐药细胞对DDP的敏感性,为卵巢上皮癌耐药的治疗提供新靶点。     

NAC-1通过自噬介导卵巢癌细胞顺铂耐药的研究

目的:探讨NAC-1在自噬介导的卵巢癌细胞顺铂耐药中的作用。方法:Western blot及流式细胞术检测顺铂诱导的耐药卵巢癌细胞(SKOV3/DDP)自噬及凋亡过程中,NAC-1蛋白的表达情况。采用siRNA下调NAC-1表达,检测其对SKOV3/DDP细胞自噬及凋亡的影响,并检测其对顺铂耐药性的影响。结果:顺铂处理SKOV3/DDP细胞后,细胞自噬及凋亡水平升高,NAC-1蛋白表达升高。siRNA下调NAC-1基因后,顺铂处理SKOV3/DDP细胞的自噬水平降低,凋亡升高,细胞顺铂耐药性降低。结论:NAC-1基因可能通过调节自噬参与卵巢癌细胞顺铂耐药,降低NAC-1基因表达有助于提高顺铂对卵巢癌细胞的杀伤作用。     

抑癌基因SPARCL1低表达对卵巢癌耐药和临床预后的影响

目的:探讨SPARCL1表达对卵巢癌顺铂耐药的影响,阐明SPARCL1表达与耐药及预后的相关性。方法:RT-qPCR和Western blot法检测卵巢癌细胞中SPARCL1表达,免疫组化法(IHC)检测卵巢癌组织中SPARCL1表达,Kaplan-Meier生存曲线分析基因表达与无疾病生存期(DFS)和总生存期(OS)的关系。慢病毒转染过表达或干扰基因在顺铂耐药细胞SKOV3/DDP中的表达,CCK-8法检测细胞增殖并计算IC_(50)。转录组测序研究SPARCL1表达对卵巢癌细胞分子水平的影响。结果:与卵巢癌敏感组织相比,SPARCL1蛋白在耐药组织中显著低表达(P=0.001),且该蛋白低表达能预测卵巢癌不良DFS(P=0.001)和OS(P=0.021)。SPARCL1在顺铂耐药细胞SKOV3/DDP中显著下调表达,其过表达能减缓耐药细胞增殖速度并提高对顺铂的敏感性,而干扰其表达则能加快细胞增殖并降低细胞对顺铂的敏感性。转录组测序结果发现,SPARCL1过表达可能影响p53及细胞黏附分子等经典卵巢癌耐药调控通路。结论:SPARCL1低表达促进耐药且与不良OS和DFS显著相关,有望作为卵巢癌治疗靶标和潜在预后标记物应用于临床。     

卵巢癌拓扑替康耐药细胞株的建立及其生物学特性

目的 :建立卵巢癌拓扑替康 (TPT)耐药细胞株 ,研究其生物学特性。方法 :用浓度梯度递增法建立卵巢癌TPT耐药细胞株。用四甲基偶氮唑蓝 (MTT)比色法检测此耐药株对多种化疗药物的耐药指数 ;用细胞计数法描绘两株细胞的生长曲线并计算群体倍增时间 ;用流式细胞仪检测两株细胞的凋亡率及周期分布 ;荧光显微镜及透射电镜下观察亲本细胞、敏感细胞及耐药细胞的超微结构。结果 :历时 6个月建立了卵巢癌TPT耐药细胞株A2 780 /TPT。此细胞株对TPT及米托蒽醌 (MX)耐药 ,耐药指数分别为 2 5及 19,对喜树碱 (CPT)轻微耐药 ,耐药指数为 3,对其他多种化疗药物不交叉耐药。耐药细胞的生长速度比亲本细胞慢 (P <0 .0 5 ) ,且细胞凋亡率及G2 M期细胞比例较亲本细胞高 (P <0 .0 5 )。敏感细胞呈典型的凋亡形态特征 ,而耐药细胞凋亡核的数量明显减少 ,凋亡程度明显减轻 ,且仍有较多的细胞核形态正常。结论 :所建立的卵巢癌TPT耐药株具有耐药细胞的基本生物学特征 ,且该耐药模型稳定。     

Expression of cellular apoptosis susceptibility protein in serous ovarian carcinoma: a clinicopathologic and immunohistochemical study

OBJECTIVE: This study investigated the expression of cellular apoptosis susceptibility protein (CAS) in serous ovarian carcinoma by immunohistochemistry and compared it with topoisomerase IIalpha (topo IIalpha), bcl-2, bcl-x, the frequency of apoptotic bodies (ABI), mitotic activity, and c-erbB-2 with regard to clinicopathologic variables. METHODS: Formalin-fixed, paraffin-embedded archival tissue sections of 10 benign serous cystadenomas, 10 serous neoplasms of low malignant potential (LMP), and 41 serous ovarian carcinomas were immunostained with antibodies to CAS, bcl-x, topo IIalpha, bcl-2, and c-erbB-2. Immunostaining for CAS, bcl-x, and bcl-2 was scored concerning approximate percentage of positive tumor cells and relative staining intensity. For c-erbB-2, at least 10% of tumor cells had to display membrane staining. Topo IIalpha-labeling indices were quantitated as the percentage of positively stained nuclei in 1000 tumor cells. ABIs were reported as the number of apoptotic bodies in 1000 tumor cells, mitotic activity as mitotic figures per 10 high power fields. RESULTS: CAS expression was negative in serous cystadenomas and LMP. In contrast, moderate or strong immunostaining was observed in 34 of 41 cases (83%) of serous carcinomas. CAS immunoreactivity was positively related with ABI (P = 0.0170), mitotic activity (P < 0.0001), c-erbB-2 (P = 0.0153), grade (P = 0.0107), and adverse outcome (P = 0.0035), but not with FIGO stage, topo IIalpha, bcl-2, and bcl-x. Other variables indicating outcome were topo IIalpha, c-erbB-2, and ABI. CONCLUSIONS: CAS is frequently upregulated in serous ovarian carcinomas, correlated with apoptosis and mitotic activity, and relevant prognostically. CAS protein expression may serve as a marker of aggressive tumor behavior in serous ovarian carcinomas.     

Gene expression and pathway analysis of ovarian cancer cells selected for resistance to cisplatin, paclitaxel, or doxorubicin

Background

Resistance to current chemotherapeutic agents is a major cause of therapy failure in ovarian cancer patients, but the exact mechanisms leading to the development of drug resistance remain unclear.

Methods

To better understand mechanisms of drug resistance, and possibly identify novel targets for therapy, we generated a series of drug resistant ovarian cancer cell lines through repeated exposure to three chemotherapeutic drugs (cisplatin, doxorubicin, or paclitaxel), and identified changes in gene expression patterns using Illumina whole-genome expression microarrays. Validation of selected genes was performed by RT-PCR and immunoblotting. Pathway enrichment analysis using the KEGG, GO, and Reactome databases was performed to identify pathways that may be important in each drug resistance phenotype.

Results

A total of 845 genes (p < 0.01) were found altered in at least one drug resistance phenotype when compared to the parental, drug sensitive cell line. Focusing on each resistance phenotype individually, we identified 460, 366, and 337 genes significantly altered in cells resistant to cisplatin, doxorubicin, and paclitaxel, respectively. Of the 845 genes found altered, only 62 genes were simultaneously altered in all three resistance phenotypes. Using pathway analysis, we found many pathways enriched for each resistance phenotype, but some dominant pathways emerged. The dominant pathways included signaling from the cell surface and cell movement for cisplatin resistance, proteasome regulation and steroid biosynthesis for doxorubicin resistance, and control of translation and oxidative stress for paclitaxel resistance.

Conclusions

Ovarian cancer cells develop drug resistance through different pathways depending on the drug used in the generation of chemoresistance. A better understanding of these mechanisms may lead to the development of novel strategies to circumvent the problem of drug resistance.     

三磷酸腺苷-肿瘤体外药敏试验联合耐药基因检测预测原发性卵巢癌的化疗敏感性

目的 评价三磷酸腺苷-肿瘤体外药敏试验(ATP-TCA)联合耐药基因检测预测原发性卵巢癌的化疗敏感性,为临床治疗提供参考.方法 选择2008-2009年间收治的接受肿瘤细胞减灭术的原发性卵巢癌患者47例,采用ATP-TCA检测卵巢癌患者对顺铂、卡铂、紫杉醇、紫杉醇+卡铂4种方案的体外药物敏感性,采用实时逆转录(RT)PCR技术检测其中46例(1份冻存的癌组织标本因降解较严重未予检测mRNA)卵巢癌患者的癌组织中耐药基因--BRCA1、ERCC1 mRNA的表达水平.采用x2检验分析ATP-TCA检测结果 与卵巢癌患者临床病理指标的相关性;采用ATP-TCA联合耐药基因检测预测卵巢癌患者对紫杉醇+卡铂方案的化疗敏感性.结果 (1)卡铂、顺铂、紫杉醇+卡铂3种方案的ATP-TCA检测结果 与临床疗效均有明显的相关关系(P<0.05),其中紫杉醇+卡铂方案的ATP-TCA检测结果 与临床疗效的符合率最高,达83%(39/47);而紫杉醇方案的ATP-TCA检测结果 与临床疗效无明显相关关系(P>0.05).紫杉醇+卡铂方案的ATP-TCA检测结果 预测临床疗效的灵敏度、特异度、阳性预测值、阴性预测值分别为90%、71%、84%、80%.紫杉醇+卡铂方案的ATP-TCA检测结果 与残瘤灶直径(P=0.023)、有无新辅助化疗(P=0.011)有明显相关关系.(2)临床化疗敏感和耐药患者BRCA1 mRNA的表达水平分别为0.673±2.143和-1.436±2.594,两者比较,差异有统计学意义(P=0.008);ERCC1 mRNA的表达水平分别为-0.529±1.982和-3.188±2.601,两者比较,差异也有统计学意义(P=0.001);BRCA1和ERCC1 mRNA的表达与临床疗效有明显的相关关系(P<0.01).(3)ATP-TCA联合耐药基因检测,预测临床应用紫杉醇+卡铂方案可能会发生耐药的准确率达到8/9.结论 ATP-TCA是一种比较理想的体外药敏检测方法,可以有效地预测临床化疗敏感性;ATP-TCA联合耐药基因检测可以提高预测卵巢癌临床化疗敏感性的准确率,指导卵巢癌的个体化治疗.

Abstract：

Objective To predict clinical chemotherapy sensitivity of primary ovarian cancer by jointing adenosine triphosphate(ATP) - tumor chemo-sensitivity assay(TCA) method in vitro and detection of drug resistance genes, provide reference for clinical treatment. Methods Forty-seven primary epithelial ovarian tumor samples were collected from the patients who received cytoreductive surgery. Viable ovarian cancer cells obtained from malignant tissue were tested for their sensitivity to carboplatin (CBP), cisplatin (DDP), paclitaxel(PTX) and CBP + PTX using ATP-TCA method in vitro; at same time, real-time quantitative PCR was used to analysis BRCA1 and ERCC1 mRNA relative expression in forty-six specimens (1 frozen tumor samples mRNA were not detected due to serious degradation). The relationship between ATP-TCA test results, clinical indicators, and the effectiveness of the joint prediction on clinical chemosensitivity by combining these two methods were statistically analyzed using chi-square test. Results (1)The results showns that three programs of DDP,CBP and PTX + CBP were significantly related with clinical results(P<0.05) in vitro, in which the compliance rate in PTX + CBP program was the highest 83%(39/47) ,and the predictive sensitivity, predictive specificity, positive predictive value, negative predictive value and predictive accurate rate were 90%,71%,84% and 80% ,respectively.PTX + CBP combined in vitro test results was also related with residual tumor size and neoadjuvant chemotherapy, which was more prone to drug resistance with residual tumor larger than 2 cm (P = 0. 023) and with neoadjuvant chemotherapy (P = 0.011). (2) BRCA1 mRNA expression levels in the clinical-resistant group and the clinical-sensitive group was 0.673 ± 2.143 and - 1.436 ± 2.594 (P=0.008), ERCC1 mRNA expression levels in the clinical-resistant group and the clinical-sensitive group was -0.529 ± 1.982 and - 3.188 ±2.601 (P =0.001). There were also significant correlation among the expression levels of BRCA1 ,ERCC1 mRNA and clinical efficacy (P<0.01). (3)ATP-TCA and detection of drug resistance genes combined to predict the clinical application of PTX + CBP resistance may occur in 8/9 cases. Conclusions ATP-TCA may be an ideal method of in vitro drug sensitivity testing method, which could effectively predict clinical chemotherapy sensitivity. Combination of the drug-resistant associated genes detection method and the ATP-TCA method can increase the predictive effectiveness of ovarian cancer chemosensitivity and guide individual chemotherapy of ovarian cancer.     

耐药相关基因在卵巢癌组织中的表达及其临床意义

目的 通过测定多药耐药基因（ＭＤＲ１,多药耐药相关蛋白（ＭＲＰ）,肺耐药相关蛋白（ＬＲＰ）和谷胱甘肽Ｓ－转移酶（ＧＳＴ－π）的卵巢癌组织中的表达,了解其在卵巢癌化学治疗耐药中的作用。方法 采用逆转录－聚合酶链反应（ＲＴ－ＰＣＲ）测定了４１例卵巢癌,２５例良性卵巢肿瘤和１２例正常卵巢组织中ＭＤＲ１,ＭＲＰ,ＬＲＰ和ＧＳＴ－π的表达,并分析其与临床,病理特征的关系。结果 （１）在正常卵巢,良性卵巢肿瘤     

Differences of chemoresistance assay between invasive micropapillary/low-grade serous ovarian carcinoma and high-grade serous ovarian carcinoma

The objective of this study was to evaluate the pattern of chemoresistance in invasive micropapillary/low-grade serous ovarian carcinoma (invasive MPSC/LGSC) and high-grade serous ovarian carcinoma (HGSC) according to extreme drug resistance (EDR) assay testing. Surgical specimens of 44 recurrent ovarian cancer patients harvested at the time of cytoreductive surgery between August 1999 and February 2004 were identified retrospectively from the tumor registry database. Thirteen patients (29.5%) had recurrent invasive MPSC/LGSC and 31 (70.5%) patients had recurrent HGSC. Eight drugs were evaluated; EDR assay results were compared between LGSC and HGSC groups using Fisher exact tests and exact logistic regression models. Compared to HGSC, invasive MPSC/LGSC were more likely to manifest EDR to the drugs paclitaxel (69% vs 14%, P < 0.001), carboplatin (50% vs 17%, P= 0.05), cyclophosphamide (40% vs 23%, P= 0.41), gemcitabine (36% vs 19%, P= 0.40), and cisplatin (33% vs 28%, P= 0.72) and less likely to be resistant to etoposide (0% vs 44%, P= 0.007), doxorubicin (8% vs 45%, P= 0.03), and topotecan (8% vs 21%, P= 0.65). Exact logistic regression estimates revealed that invasive MPSC/LGSC patients had significantly increased probabilities of paclitaxel resistance odds ratio (OR) = 12.5 (95% CI: 2.3-100.0), P= 0.001 and carboplatin resistance OR = 4.8 (95% CI: 0.9-25.0), P= 0.07, while the HGSC cases were more likely to be resistant to etoposide OR = 12.1 (95% CI: 1.7-infinity), P=0.009 and doxorubicin OR = 8.6 (95% CI: 1.0-413.7), P= 0.05. In this retrospective analysis, patients with recurrent invasive MPSC/LGSC were more likely to manifest EDR to standard chemotherapy agents (platinum and paclitaxel). These observations may help to guide chemotherapeutic decision making in these patients if confirmed in a large-scale study.     

绒癌耐药细胞系的建立及获得性耐药机制的研究

目的 :采用目前治疗绒癌最常用的药物诱导建立绒癌的耐药细胞系 ,比较不同药物引起耐药机制的差异。方法 :采用浓度梯度递增法和间歇诱导法 ,分别用 5 FU ,MTX ,VP 16诱导绒癌细胞系JEG 3,建立相应耐药细胞系 ,采用MTT法测定耐药细胞系对5 FU、MTX、KSM、VP 16和Taxol的耐药指数 ,用RT PCR测定亲本细胞及各耐药细胞系耐药相关基因如肺耐药蛋白 (LRP)、多药耐药相关蛋白 (MRP)、谷胱甘肽转移酶 (GST π)、二氢叶酸还原酶 (DHFR)和多药耐药基因 (MDR 1)的mRNA表达 ,比较各种细胞生长曲线 ,细胞群体倍增时间。结果 :JEG 3细胞系在诱导耐药细胞前即有LRP、MRP、GST π、DHFR的共表达 ,诱导耐药后上述各基因的表达无明显变化。诱导耐药前JEG 3细胞无MDR1的表达 ,用VP 16、5 FU间歇诱导的方法诱导形成的耐药细胞系有MDR 1表达 ,且耐药指数增加。结论 :JEG 3耐药细胞系耐药性的产生与MRP、LRP、GST π、DHFR表达的关系不密切 ,而与MDR1的表达有关。     

地诺孕素、亮丙瑞林辅助治疗卵巢子宫内膜异位囊肿的临床效果比较#br#

Objective?To compare the efficacy of different drugs in adjuvant treatment of ovarian endometrioma. Methods?A total of 170 patients with ovarian endometriosis cysts were randomly divided into dienogest group (dienogest treatment) and leuprolide group (leuprolide treatment), 85 cases in each group. The curative effects of the two groups were compared, and the follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), carbohydrate antigen 125 (CA125), endometrial thickness, uterine volume, and antral follicle count (AFC) were observed in the two groups, ovarian stromal blood flow resistance index (RI), pulsatility index (PI) changes. Results?There was no significant difference in the total effective rate, endometrial thickness, uterine volume, CA125 level and AFC between the two groups (P>0.05); the levels of FSH, E2, LH, RI, and PI in the leuprolide group were lower than those in the dinoflagellate group. There was no significant difference in endometrial thickness, uterine volume, CA125 or AFC between the two groups after treatment (P＞0.05). After treatment, RI in leuprolide group was lower than that in dienogest group (P<0.05). Conclusion?The effects of dienogest and leuprolide on ovarian endometrioma cysts are similar, but adjuvant leuprolide therapy can be more beneficial to improve ovarian blood supply.