CAJ | 학술논문

目的　检测各种类型肺癌化疗前及化疗后复发病例P-gp蛋白的表达情况，探讨其与肺癌多药耐药及患者预后的关系。方法　采用免疫组化染色方法对66例化疗后复发病例及131例未经化疗的肺癌病例进行耐药基因MDR1表达蛋白P-gp检测。结果　化疗后复发病例P-gp阳性表达率明显高于未经化疗的病例（P＜0.05)，其中，鳞癌、小细胞癌化疗后P-gp阳性表达率均明显高于化疗前（P＜0.05），而肺腺癌则无明显差异（P＞0.05）。未经化疗组不同病理类型的肺癌P-gp蛋白阳性表达率有显著性差异，从高到低依次为腺癌、鳞癌和小细胞癌（P＜0.05）。化疗后复发组各病理类型肺癌中P-gp蛋白阳性表达率无显著性差异（P＞0.1)。P-gp表达阳性的患者3年生存率明显低于阴性者(P＜0.05)。结论　化疗可能诱导各种病理类型肺癌P-gp蛋白表达增加。肺鳞癌和小细胞肺癌可能为获得性MDR1耐药，肺腺癌是原发性MDR1耐药。肺癌患者P-gp表达程度可作为指导化疗用药及预测预后的指标。
목적　검측각충류형폐암화료전급화료후복발병례P-gp단백적표체정황，탐토기여폐암다약내약급환자예후적관계。방법　채용면역조화염색방법대66례화료후복발병례급131례미경화료적폐암병례진행내약기인MDR1표체단백P-gp검측。결과　화료후복발병례P-gp양성표체솔명현고우미경화료적병례（P＜0.05)，기중，린암、소세포암화료후P-gp양성표체솔균명현고우화료전（P＜0.05），이폐선암칙무명현차이（P＞0.05）。미경화료조불동병리류형적폐암P-gp단백양성표체솔유현저성차이，종고도저의차위선암、린암화소세포암（P＜0.05）。화료후복발조각병리류형폐암중P-gp단백양성표체솔무현저성차이（P＞0.1)。P-gp표체양성적환자3년생존솔명현저우음성자(P＜0.05)。결론　화료가능유도각충병리류형폐암P-gp단백표체증가。폐린암화소세포폐암가능위획득성MDR1내약，폐선암시원발성MDR1내약。폐암환자P-gp표체정도가작위지도화료용약급예측예후적지표。
Objective　To investigate the relationship between multidrug resistance(MDR) and chemotherapy and the possibility of P-gp as a clinical prognostic indicator. Methods　P-gp, MDR1 gene product, was detected in 66 cases of relapsed lung cancer patients after chemotherapy and 131 lung cancer patients with no prior chemotherapy by immunohistochemistry. Results　The expressive level of P-gp in relapsed group after chemotherapy was much higher than that of non-chemotherapy group (P＜0.05). A significant difference of P-gp expression existed between before and after chemotherapy for squamous cell carcinoma and SCLC (P＜0.05), but not for adenocarcinoma. In non-chemotherapy group, lung cancer tissues with different histological types had different P-gp positive rates, which were adenocarcinoma, squamous cell carcinoma and SCLC in sequence from high to low (P＜0.05). In relapsed group after chemotherapy, there was no significant difference among the three types of lung cancer (P＞0.05). P-gp positive group had a significantly lower 3-year survival rate than negative group (P＜0.05). Conclusion　Chemotherapy may increase the incident rate of MDR in lung cancer. Adenocarcinoma is mainly primary MDR while SCLC and squamous cell carcinoma are mainly secondary to chemotherapy. P-gp expressive level can be used as a common clinical indicator for prognosis and chemotherapy in the patients with lung cancer.