Survivin和Bcl-2蛋白在胃癌细胞中的表达及其与化疗药物耐药性关系的研究

目的:检测Survivin和Bcl-2蛋白在胃癌组织中的表达，探讨Survivin和Bcl-2基因与胃癌化疗药物耐药性的关系。方法:取新鲜胃癌手术标本98例，免疫组化检测Survivin和Bcl-2蛋白在胃癌组织中的表达。同时进行原代胃癌细胞培养，MTT比色法检测原代培养细胞对化疗药物HCPT、CDDP、5－FU、ADM和MMC的敏感性。结果:胃癌组织中Survivin和Bcl-2蛋白的阳性率分别为74.5%和70.4%。Survivin阳性表达者对5－FU和ADM的耐药性显著高于阴性者，差异有统计学意义（P<0.05）。5-FU、ADM和MMC三种药物对Bcl-2阳性表达者的抑制率显著低于Bcl-2阴性表达者（P<0.05），其阳性表达与5-FU、ADM及MMC的体外耐药相关。结论:Survivin和Bcl-2基因与胃癌对化疗药物敏感性相关，Survivin与胃癌细胞原发性化疗耐受有关，检测其表达对选择化疗药物有实用价值。Bcl-2可能参与介导胃癌细胞的耐药，其高表达可能是胃癌多药耐药产生的原因之一。

The relationship between Survivin and Bcl- 2 expression and chemoresistance in gastric carcinoma

Objective：To detect the expression of Survivin and Bcl -2 in gastric carcinoma, and investigate the re- lationship between Survivin and Bcl - 2 expression and the drug - resistance to chemotherapeutic - drugs. Methods： All 98 samples of gastric cancer were collected, Survivin and Bcl - 2 were detected by immunohistochemistry. Primary single - cell suspensions were prepared from fresh specimens of primary gastric cancer and exposed to hydroxycampto- thecin （ HCPT ）, cisplatin （ CDDP）, 5 - fluorouracil （5 - FU）, adriamycin （ADM） and mitomycin （MMC） for 48 h. Cell metabolic activity and rate of inhibition were evaluated using tetrazolium（MTI＇） assay. Results： Positive rates of Sur- vivin and Bcl -2 in gastric cancer were 74.5 % and 70.4 %, respectively. Survivin positive cells showed more tolerant to 5 - FU and ADM than the negative cells （ P 〈 0.05 ） ; Inhibited rate of the Bcl - 2 positive cells was remarkably higher than the Bel - 2 negative cells in 5 - FU, ADM and MMC. Conclusion： Expression of Survivin and Bcl - 2 was correlated with primary drug -resistance of gastric cancer, and Survivin may be related with primary tolerance of gas- tric cancer to chemotherapeutic - drugs, which could be used as predictors in gastric carcinoma drugs administration. Bcl - 2 was likely intervene drug - resistance, and its high expression could be a cause of muhidrug resistance in gas- tric cancer.