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目的:从细胞核水平对肾癌多药耐药(multldrugresistance,MDR)机制进行探讨,以期为选择化疗方案提供参考,获得更有效的化疗效果.方法:应用免疫组化的方法,对肾癌MDR的主要耐药指标DNA拓扑异构酶Ⅱ(TopoisomeraseⅡ,TopeⅡ)进行检测,并结合临床分型、分级、分期进行研究.结果:27例正常组织均表达TopoⅡ(100％),主要位于胞浆,70例癌组织均有TopoⅡ表达(100％),均位于胞核,TopoⅡ值以≥100为阳性标准,仅21.6％为阳性.结论:肾癌TopoⅡ表达值降低,使大多数化疗药物丧失了作用靶点而产生MDR.选择TopoⅡ高表达的患者采用不同的化疗药物进行化疗将有助于提高化疗有效率.“,”Purpose Renal cell carcinoma (RCC) is one of the most drug-resistant tumors. The chemothera-py efficiency is only 7 % ~ 10 %, which is one of main cause of poor prognosis in RCC. By studying the mecha-nisms of MDR, We attend to find the reference for chemotherapy plan. Methods To study the mechanism ofMDR in Roc, 7o cases of paraffin-embedded Roc tissue sections were analyzed for the presence of Tope Ⅱ bymeans of immunohistochemistry. Results 100% normal kidney tissue expressed Tope Ⅱ, the Positive staininglocated in plasma, somewhat including nuclei. 100% of RCC also had the expression of Tope Ⅱ, but only thenuclei had the positive staining. Conclusion Most of chemotherapy drugs lose their target and effect becausethe downregulation of Tope Ⅱ. According to the research, we suggested that the patients with high index ofTope Ⅱ is the best indication of chemotherapy. Electing different drug according to mechanism should be thekey to improve the efficiency of chemotherapy.