膀胱癌多药耐药基因产物的表达及临床意义

目的探讨膀胱癌组织的多药耐药基因（mdr－1）产物P-糖蛋白（P-GP）的表达情况。方法应用LSAB免疫组化技术研究25例初发膀胱癌及16例复发膀胱癌的P－GP阳性表达。结果初发膀胱癌P－GP阳性表达率48％，复发膀胱癌P-GP阳性表达率87.5％，复发性膀胱癌P－GP阳性表达率明显高于初发肿瘤（P＜0.05）。不同病理分级、临床分期间的P－GP阳性表达率无显著性差异（P＞005）。结论膀胱癌的P－GP阳性表达水平与肿瘤病理分级及临床分期无关。复发性膀胱癌有较高的P－GP表达是由于肿瘤接触化疗药物后，mdr－1基因扩增所致。P－GP的过度表达可能是膀胱癌腔内化疗失败的重要原因之一。

Expression of mdr-1 gene product in bladder cancer and its clinical significance

Objective To detect the expression of p-glycoprotein (P-GP) encoded by multidrug resistance (mdr-1) gene in bladder cancer. Method Positive expression of P-GP was studied by using labeled strepavidinbiotin in 25 cases of primary bladder cancer and in 16 cases of recurrent bladder cancer. Result Positive expression of P-GP was 48% in primary bladder cancer, and 87. 5% in recurrent bladder cancer following chemotherapy. The recurrent bladder cancer had a higher positive expression rate than primary bladder cancer (P < 0. 05). No correlation was found between the pathological grade, and the clinical stage for expression of P-GP (P >0. 05). Conclusion The level of P-GP expression was not correlated with the tumor pathological grade and malignant behavior. The tumor contacting chemotherapeutic drug might cause mdr-1 gene amplification and a higher expression of P-GP in recurrent bladder cancer, which might be an important factor in intravesical chemotherapeutic treatment failure.