耐药基因检测及体外药敏试验在卵巢癌个体化治疗中的价值

目的 探讨卵巢癌耐药基因表达与体外药敏试验及临床生物学行为的关系.方法 采用流式细胞术和MTT法对60例卵巢癌患者分别检测组织中的COX-2、CX43、P-gp基因表达和对常用化疗药物的敏感性,并对其临床近期疗效关系进行分析.结果 COX-2表达在顺铂(DDP)耐药组高于DDP敏感组,差异有统计学意义(P=0.01).CX43表达在DDP耐药组低于DDP敏感组,差异有统计学意义(P=0.005).P-gp表达在对依托泊苷(VP16)耐药组高于VP16敏感组,差异有统计学意义(P=0.009).CX43表达在对紫杉醇(Taxol)耐药组低于Taxol敏感组.差异有统计学意义(P=0.001).COX-2高表达、CX43低表达、P-gp高表达的癌组织对化疗药物的敏感性低于COX-2低表达、CX43高表达、P-gP低表达者.5-Fu、CBP、VCR、PYM、EPI、GEM的敏感性与COX-2、CX43、P-gp表达高低无显著相关性.结论 卵巢癌组织中COX-2与P-gp高表达、CX43低表达与部分化疗药物的体外药敏试验敏感性有关.耐药基因相关蛋白COX-2、P-gp、CX43的检测,结合肿瘤药敏试验结果选择敏感化疗方案能提高化疗疗效.从而使卵巢癌治疗个体化.

Value of the expression of drug-resistance gene and in vitro drug-sensitivity test in tissue of patients with ovarian carcinoma by individualized treatment

Objective To study the relation between the expression of drug-resistance gene and in vitro drug sensitivity test in ovarian carcinoma and clinical biological behavior.Methods In 60 primarily treated patients with epithelial ovarian carcinoma,the expression of COX-2,Connexin43(CX43)and P-gp was detected using flow cytometry.Sensitivity of cells of short term in vitro culture to anticancer drugs was also examined by the game techniques.Remits The expression level of COX-2 was higher in tissue with DDP-resistance patients than those with sensitivity patients but the expression level of CX43 was lower in tissue with DDP-resistance and Taxol-resistanee patients than those with sensitivity patients.The expression level of P-gp was higher in tissue with VP16-resistance patients than those with sensitivity patients.The sensitivity of DDP,Taxol and VP16 was lower in tissue with higher expression of COX-2 and P-gp than those with lower expression of COX-2 and P-gp.The sensitivity of DDP and Taxol was higher in tissue with higher expression of CX43 than those with lower expression of CX43.Conclusion The in vitro sensitivity of some of the drugs is effected by tissues with expression of COX-2,P-gp and CX43.It is not only useful but also individualized treatment for application of sensitive drug test and detecting the expression of COX-2,P-gP and CX43 to increase the response rate of chemotherapy in patients with epithelial ovarian carcinoma.