NSCLC患者外周血淋巴细胞多药耐药基因的表达与长春瑞滨化疗疗效的相关性研究

目的：检测多药耐药基因（MDR-1）在非小细胞肺癌患者外周血淋巴细胞中的表达，探讨MDR-1的表达与肺癌的病理类型及分期的关系及与长春瑞滨联合铂类化疗疗效之间的关系。方法：采用逆转录聚合酶链反应（RT—PCR）技术检测46例非小细胞肺癌患者外周血中MDR-1的表达水平，并与30例健康对照组进行比较。非小细胞肺癌患者均采用NP方案治疗，2个治疗周期后评价疗效。结果：非小细胞肺癌组外周血淋巴细胞MDR-1阳性检出率36．95％（17／46），其中腺癌9例阳性，鳞癌7例阳性，腺鳞癌1例阳性，Ⅰ期1例阳性，Ⅱ期3例阳性，Ⅲ期7例阳性，Ⅳ期6例阳性，而健康对照组仅1例阳性。MDR-1表达阳性的非小细胞肺癌患者应用长春瑞滨联合铂类化疗的有效率明显低于MDR-1表达阴性者，差异具有统计学意义。结论：非小细胞肺癌患者外周血淋巴细胞MDR-1表达水平较高，与肺癌的病理类型及分期无关；与长春瑞滨联合铂类化疗的临床疗效具有一定的相关性，临床上可根据MDR—1表达情况，制定个体化的化疗方案。

Relation between MDR-1 expression in patients with non-small cell lung cancer and chemotherapy effect with vinorelbine combined with cisplatin

Objective:To detect the expression of MDR-1 in peripheral blood lymphocytes of non-small cell lung cancer patients,and investigate the relation between MDR-1 expression and pathology and clinical stage,clinical efficacy of chemotherapy with vinorelbine combined with cisplatin.Methods:The expression of MDR-1 was tested in 46 non-small cell lung cancer cases using RT-PCR technique,and the results were compared with 30 normal control cases.The treatment of non-small cell lung cancer patients were adopted NP chemotherapy regimens,and the efficacy was evaluated after 2 circles.Results:The positive rate of MDR-1 in non-small cell lung cancer was 36.95%(17/46),and there was only one positive case in normal control cases,there was statistic significance.Among patient group,there were 9 positive cases in adenocarcinoma,7 positive cases in squamous carcinoma,1 positive case in adenosquamous carcinoma,0 positive case in large cell carcinoma;1 positive cases in I stage,3 positive cases in II stage,7 positive cases in III stage,6 positive cases in IV stage;no statistic significance were found not only in pathology groups but also in clinical stages.In patient group,the effective rate of NP chemotherapy regimens in positive patients was much lower than that of patients with negative expression.Conclusion:The expression of MDR-1 was higher in peripheral blood lymphocytes of non-small cell lung cancer patients,and not related to pathological type and clinical stage,but related to clinical efficacy of vinorelbine plus cisplatin.