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目的 探讨鼻咽癌组织的多药耐药基因的表达及其与化疗敏感性的关系。方法 应用单克隆抗体多药耐药基因蛋白 (P-glycoprotein,P-gp)、多药耐药相关蛋白 (multidrugresistancerelationprotein,MRP)、肺耐药相关蛋白 (lung resistancerelatedprotein,LRP)、拓朴异构酶 (topoisomeeraseⅡ,TopoⅡ)、胸腺肽合成酶(thymidylatesynthase,TS)、谷胱甘肽转移酶 (glutathione S transferase,GST-π),对 23例鼻咽癌患者的肿瘤组织进行免疫组化检测。其中 20例是治疗前鼻咽部原发灶活检组织,这20例患者用顺氯氨铂(diamminedichloroplatinum,DDP) +5 氟尿嘧啶 (5-fluorouracil, 5-FU)进行 2个疗程化疗; 3例是鼻咽癌治疗后颈部淋巴结复发,进行颈清扫术的标本。结果 除 1例病理类型为透明细胞癌之外,各项多药耐药指标在 22例患者中均有不同程度表达,成组秩和检验,各项的表达程度差异有统计学意义,P<0.05。不同细胞类型(原发鳞状细胞癌、泡状核细胞癌、透明细胞癌 )和临床分期(Ⅱ~Ⅲ期)的多药耐药表达采用成组秩和检验差异无统计学意义 (P值均 >0.05)。LRP和TS表达阳性分别是 10例和 14例,化疗有效率分别为 20% (2 /10)和 28 5% (4 /14);而表达阴性组化疗有效率分别为 70% (7 /10)和 5 /6,二者比较,P值均 <0.05,差异?
Objective To investigate the expression of multidrug resistance gene in nasopharyngeal carcinoma and its relationship with chemosensitivity. Methods P-glycoprotein (P-gp), multidrug resistance protein (MRP), lung resistance related protein (LRP), topoisomeeraseⅡ , TopoⅡ, thymidylatesynthase (TS) and glutathione S transferase (GST-π) were detected by immunohistochemical method in 23 cases of nasopharyngeal carcinoma. Twenty of them were biopsy tissues of the nasopharynx before treatment. These 20 patients underwent two courses of chemotherapy with diamminedichloroplatinum (DDP) and 5-fluorouracil (5-FU), and three were Cervical lymph nodes after nasopharyngeal carcinoma recurrence, neck dissection specimens. Results Except for 1 case of clear cell carcinoma, the multidrug resistance markers were all expressed in different degrees in all 22 cases, and the rank sum test showed that the expression levels of all the cases were statistically significant (P < 0.05. The expression of multi-drug resistance in different cell types (primary squamous cell carcinoma, vesicular cell carcinoma, clear cell carcinoma) and clinical stage (stage Ⅱ ~ Ⅲ) were not significantly different by group rank sum test (P value All> 0.05). The positive rates of LRP and TS were 10 cases and 14 cases respectively, and the effective rates of chemotherapy were 20% (2/10) and 28 5% (4/14) respectively; while those in negative group were 70% (7/10 ) And 5/6, the two were compared, P <0.05, the difference?