喉癌组织多药耐药表型与肿瘤化疗反应的关系

目的 :观察喉癌患者多药耐药表型与肿瘤化疗反应的关系。方法 :对 3 6例喉癌患者 ,于诱导化疗前取癌组织标本 ,采用免疫组化法检测 P-糖蛋白 ( P- gp)。患者均接受以顺铂、5 -氟尿嘧啶和平阳霉素为方案的术前诱导化疗 ,肿瘤对化疗反应的评估分为有效 (包括完全反应或部分反应 )或无效 (包括稳定或恶化 )。结果 :3 6例中P- gp阳性 12例 ( 3 3 .3 % ) ,P- gp阴性 2 4例 ( 66.7% )。 12例 P- gp阳性患者对化疗反应有效 3例 ( 2 5 % ) ,无效 9例( 75 % ) ;2 4例 P- gp阴性患者对化疗反应有效 2 1例 ( 87.5 % ) ,无效 3例 ( 12 .5 % ) ,P- gp阳性者化疗有效率明显低于 P- gp阴性者 ( P <0 .0 5 )。结论 :本文资料显示 ,以 P- gp介导的多药耐药表型与喉癌对化疗耐药性之间存在统计学意义。

The correlation of multidrug resistance phenotype with clinical response to chemotherapy in laryngeal cancer

OBJECTIVE: The correlation of multidrug resistance(MDR) phenotype with clinical response to chemotherapy was investigated in patients with laryngeal cancer. METHOD: Tumor specimens prior to neoadjuvant chemotherapy from 36 cases of laryngeal cancer were collected for detection of P-glycoprotein (P-gp) with anti-Pgp monoclonal antibodies (JSB-I). Immunohistochemical assays were used for P-gp detection on 5 microns thick frozen section. Anti-Pgp monoclonal antibodies(JSB-I) as primary antibodies and goat anti-mouse IgG monoclonal antibodies as second antibodies were applied. All patients received preoperative induction chemotherapy with a regimen of cisplatin, 5-fluorouracil and pingyangmycin. Evaluation for tumor response was scored as follows: Response to chemotherapy was graded as good for complete response or partial response; as poor for stable disease or progressive disease. RESULT: Of the 36 pretreatment specimens, 12(33.3%) were P-gp positive and 24 (66.7%) were P-gp negative. Among the 12 patients with P-gp positive, 3(25%) had a good response and 9(75%) had a poor response. Of the 24 patients with P-gp negative, 21(87.5%) had a good response and 3(12.5%) had a poor response (P < 0.05). CONCLUSION: These preliminary data suggest that a significant correlation between MDR phenotype, Pgp-mediated and chemotherapy resistance existed.