多药耐药蛋白在结肠癌、直肠癌中的表达及临床意义

目的探讨P-糖蛋白(P-gp)、谷胱甘肽转移酶(GST-π)、拓扑异构酶(TopoⅡ)和肺耐药蛋白(LRP)在结直肠癌中的表达及临床意义。方法应用免疫组化S-P法联合检测P-gp、GST-π、TopoⅡ和LRP在80例结直肠癌组织和20例正常结直肠黏膜组织中的表达,并结合临床病理因素进行分析。结果①P-gp、GST-π和LRP在结直肠癌组织中的表达高于正常结直肠黏膜组织(前两者P<0.05,后者P>0.05),TopoⅡ在结直肠癌中的表达低于正常结直肠黏膜组织(P<0.05)。②高分化腺癌、中分化腺癌、低分化腺癌P-gp、GST-π和LRP的表达率由高到低;TopoⅡ的表达率由低到高。③P-gp、GST-π、TopoⅡ和LRP在浸润黏膜及黏膜下层组、肌层组与浆膜及浆膜外组表达率3组之间均无显著差别(P>0.05)。④P-gp、GST-π和LRP在有淋巴结转移组的表达率高于无淋巴结转移组(P<0.05)。⑤P-gp、GST-π、TopoⅡ和LRP在结直肠癌中的表达两两之间无相关性。结论P-gp、GST-π、TopoⅡ和LRP均在结直肠癌原发性多药耐药中起重要作用。联合检测P-gp、GST-π、TopoⅡ和LRP对于结直肠癌判断预后、制定化疗方案有一定的指导意义。

EXPRESSION AND CLINICAL SIGNIFICANCE OF MDR-P IN CARCINOMA OF THE COLON AND RECTUM

Objective To study the clinical significance of P-glycoprotein(P-gp),glutathione-s-trannsferase(GST-π),DNA topoisomerase(TopoⅡ) and lung resistance protein(LRP) expression in carcinoma of the colon and rectum tissue.Methods The expression of P-gp,GST-π,TopoⅡand LRP in 80 cases of carcinoma of the colon and rectum and 20 cases of normal tissues were detected by S-P immunohistochemical technique,and its correlation to clinical pathologic characteristics of carcinoma was explored.Result ① The expression rates of P-gp,GST-π,and LRP in carcinoma of the colon and rectum were all higher than those in normal tissues(P<0.05,P<0.05,P>0.05),while the expression rate of TopoⅡ in carcinoma of the colon and rectum was lower(P<0.05).② The expression rates of P-gp,GST-π and LRP in well-moderated differentiation adenocarcinoma were significantly higher than those in poor differentiation adenocarcinoma(P<0.05),while TopoⅡis opposite(P<0.05).③ There was no significant differentiation of the expression rates of P-gp,GST-π,TopoⅡand LRP among the group invading mucoma and submocuma,the group invading musculairs and the group invading serosa and beyond serosa(P>0.05).④ The expression rates of P-gp,GST-π and LRP in group with lymph metastasis were significantly higher than those in group without lymph node metastasis(P<0.05).⑤ There was no correlation in any two items among the expression levels of P-gp,GST-π,TopoⅡand LRP.Conclusion P-gp,GST-π,TopoⅡand LRP play important roles in the primary MDR of the colon and rectum carcinoma.Thedetermination of P-gp,GST-π,TopoⅡand LRP may be useful for the estimate of prognosis and the establishment of chemical therapy regimen in colon and rectum carcinoma.