老年患者胃癌组织的体外化疗药敏性与凋亡抑制蛋白p53、生存素、Bcl-2表达的关系

目的探讨老年患者胃癌肿瘤组织的体外化疗药物敏感性与凋亡抑制蛋白表达的关系。方法 MTT法检测65例老年胃癌患者(≥65岁)及58例对照组患者(<65岁)肿瘤细胞原代培养药物敏感性。应用免疫组化法检测肿瘤组织凋亡抑制蛋白p53、生存素和Bcl-2的表达。结果10种化疗药物中,氟尿嘧啶(5-FU)、长春新碱(VCR)、奥沙利铂(L-OHP)、表阿霉素(eADM)、丝裂霉素(MMC)对老年患者肿瘤细胞的抑制率低于对照组(P<0.05)。老年组生存素、Bcl-2表达高于对照组(P<0.01),且两者表达存在正相关性(P<0.05);对照组p53的表达与Bcl-2存在正相关(P<0.01)。老年胃癌患者p53的表达与紫杉醇(PTX)、顺铂(CDDP)对肿瘤细胞的抑制率呈负相关(P<0.01),生存素与5-FU、PTX、L-OHP、CDDP、eADM的抑制率呈负相关(P<0.05),Bcl-2表达则与VCR、足叶乙甙(VP-16)、羟基喜树碱(HCPT)、PTX、吡喃阿霉素(THP)呈负相关(P<0.05);对照组p53与CDDP的抑制率呈负相关(P<0.05),生存素表达则与5-FU、VCR、HCPT呈负相(P<0.01),Bcl-2表达与VP-16、CDDP对肿瘤细胞的抑制率呈负相关(P<0.05),但与L-OHP的抑制率正相关(P<0.05)。结论老年胃癌患者与对照组存在不同的多药耐药表型,凋亡抑制蛋白在老年胃癌多药耐药中起重要作用。

Relationship between in vitro chemosensitivity and expressions of p53, survivin and Bcl-2 in the elderly with gastric cancer

Objective To investigate the relationship between in vitro chemosensitivity and expressions of inhibitory apoptosis proteins in the elderly with gastric carcinoma.Methods The in vitro chemotherapy sensitivities of fresh tumor tissues to 10 drugs were tested with MTT assay in 65 elder patients(group A,≥65 years old) and 58 subjects(group B,<65 years old).The expressions of p53,survivin and Bcl-2 in carcinoma specimens were detected by immunohistochemistry.Results The tumor inhibition rates of 5-FU,VCR,L-OHP,eADM,MMC were significantly lower in group A than those in group B(P<0.05).The expressions of survivin and Bcl-2 were significantly higher in group A than those in group B(P<0.01).The expression of survivin was positively correlated to that of Bcl-2 in group A(P<0.05).The expression of p53 was positively correlated to that of Bcl-2 in group B(P<0.01).The expression of p53 was negatively correlated to the inhibition rates of PTX,CDDP,which of survivin was negatively correlated to 5-FU,PTX,L-OHP,CDDP and eADM and which of Bcl-2 was negatively correlated to VCR,VP-16,HCPT,PTX and THP in group A(P<0.05).The expression of p53 was negatively correlated to the inhibition rates of CDDP(P<0.05),which of survivin was negatively correlated to the inhibition rates of 5-FU,VCR and HCPT,and which of Bcl-2 was negatively correlated to the inhibition rates of VP-16 and CDDP,but positively correlated to the inhibition rate of L-OHP in group B(P<0.05).Conclusion The different patterns of in vetro multidrugs resistance exist between the elderly and the younger with gastric cancer,in which inhibitory apoptosis proteins may play an important role.