消化道肿瘤凋亡抑制蛋白表达与体外化疗药物敏感性的关系

目的 探讨消化道肿瘤中p53、survivin、bcl-2蛋白表达与肿瘤细胞体外化疗药物敏感性的关系.方法 对84例胃癌和大肠癌进行MTT法体外化疗药物敏感实验和p53、survivin、bcl-2蛋白免疫组化染色,分析3种凋亡抑制蛋白与9种化疗药物对肿瘤细胞抑制的关系. 结果 本组肿瘤中p53、survivin、bcl-2蛋白表达率分别为64%、89%、61%,survivin与Bcl-2蛋白表达具有正相关性(r=0.3027,P＜0.05).p53强表达与紫杉醇、顺铂对肿瘤细胞抑制率明显降低有关(t=2.1282,P=0.0363;t=3.8850,P=0.0002);survivin蛋白强表达时,长春新碱、顺铂对肿瘤细胞的抑制率明显降低(t=2.1693,P=0.0329;t=2.0247,P=0.0046),但奥沙利铂对肿瘤细胞的抑制率明显增加(t=-2.9070,P=0.0047);bcl-2强表达时,氟尿嘧啶、长春新碱、表阿霉素、奥沙利铂对肿瘤细胞的抑制率明显低于弱表达组(t=2.1483～3.2330,P=0.0347～0.0018).结论 消化道肿瘤凋亡抑制蛋白的表达程度与部分化疗药物耐药性有关,评价某种耐药因子与肿瘤化疗药物敏感性的关系时必须考虑其他因素的影响.

Apoptosis inhibition and chemosensitivities in GI carcinomas

Objective To investigate the relationship between the expression of inhibition of apoptosis proteins like p53,survivin,bcl-2 and chemosensitivities in gastrointestinal tract carcinomas.Methods The expression of p53,survivin and bcl-2 were determined immunohjstochemically,and the chemosenisitivities to 9 drugs was measured by MTT assay in 84 tissue specimens of gastrointestinal carcinomas.Resuits Positive immunostainning for p53,survivin and bcl-2 were found in 64%,89%and 61%of cases.respectively.Correlation existed between the expression of Sllrvivin and bcl-2(r=0.3027,P＜0.05).In terms of relationship between expression of p53,survivin or bcl-2 and inhibition rates of tumor cells.the inhibition rates to PTX and DDP in p53 strong expression group were lower than those in weak group(t=2.1282,P:0.0363;t=3.8850,P=0.0002).When survivin expressed strongly,the inhibition rates for VCR and DDP decreased significantly(t=2.1693,P=0.0329;t=2.0247,P=0.0046),while that for OXA increased(t=-2.9070,P:0.0047).here were lower tumor inhibition rates for 5-FU.VCR,eADM and OXA in bcl-2 strong expression group than those in weak group(t=2.1483～3.2330,P=0.0347～0.0018,respectively).Conclusions The extent of the expression of P53.survivin or bcl-2 in gastrointestinal carcinomas was associated with the chemosensitivities of some drugs.In assessing the influence of p53,survivin or bcl-2 on durg resistance,many factors and mechanisms should be considered.