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目的 :探讨通过胃粘膜活检组织检测多药耐药基因 (MDR1)产物P -gp表达情况来指导化疗的可行性及P -gp在胃癌组织中的表达及意义。方法 :免疫组化法检测 90例胃癌胃镜活检组织及相应术后切除组织P -gp表达情况。结果 :胃镜活检组织P -gp阳性表达率为 75 6 % ,胃癌术后组织P - gp表达率为 6 6 7% ,二者均阳性表达6 0 0 % ,均阴性表达 17 7% ,吻合率 77 7% ,胃镜活检组织P - gp检测结果与术后切除组织P - gp检测结果无差别(P >0 .0 5 )。P - gp表达与病理类型、分期、分化程度及淋巴结转移状况无关 (P >0 .0 5 )。结论 :通过胃镜活检组织P - gp检测可了解机体耐药情况 ,为非手术及术前病人化疗提供依据 ,此法安全可靠、简便易行。P - gp表达与胃癌生物学行为无关 ,不宜作为肿瘤恶性度指标 ,但可作为判断化疗反应的独立预后因素。
Objective: To investigate the feasibility of chemotherapy guided by gastric mucosal biopsy to detect the expression of P-gp in multidrug resistance gene (MDR1) and the expression and significance of P-gp in gastric cancer. Methods: Immunohistochemical method was used to detect the expression of P-gp in 90 cases of gastric cancer biopsies and corresponding resected tissues. Results: The positive expression rate of P - gp in gastric biopsy was 75.6%. The expression of P - gp in postoperative tissue of gastric cancer was 66.7%, both of which were 60.0% and 17.7% The result of P - gp in gastric biopsy showed no difference with P - gp in resected tissue (P> 0.05). The expression of P - gp was not associated with pathological type, stage, degree of differentiation and lymph node metastasis (P> 0.05). Conclusion: The detection of P - gp by gastroscopic biopsy can be used to understand the drug resistance of the patients and provide basis for non - operation and preoperative chemotherapy. This method is safe, reliable and easy to operate. P - gp expression has nothing to do with the biological behavior of gastric cancer, should not be used as an indicator of tumor malignancy, but can be used as an independent prognostic factor in response to chemotherapy.