CAJ | 학술논문

目的:探讨P-糖蛋白(P-gp)、肺耐药蛋白(LRP)、多药耐药相关蛋白(MRP)和谷光甘肽转移酶(GST-π)在非小细胞肺癌(NSCLC)中的表达及其临床意义.方法:应用免疫组织化学S-P技术对86例治疗前非小细胞肺癌组织标本进行P-gp、LRP、MRP和GST-π表达的检测.结果: LRP和MRP在肺腺癌、鳞癌中的表达阳性率分别为77.78%、51.22%和80.00%、53.66%;LRP和MRP在不同组织类型中的表达有显著性差异(均P<0.05).P-gp和GST-π在肺腺癌和鳞癌中的表达阳性率分别为73.33% 、60.98%和80.00%、70.73%;P-gp和GST-π在不同组织类型中的表达无显著性差异(均P>0.05).所测4种耐药基因除P-gp外其余3种在中高分化和低分化组间表达阳性率有显著性差异(均P<0.01);4种耐药基因在TNM各分期中表达阳性率无显著性差异(均P>0.05).在肺腺癌和肺鳞癌中同时有2种、3种或4种耐药基因协同表达的阳性率分别为46.67%和34.15%、31.11%和24.39%、20.00%和17.07%,在肺腺癌和肺鳞癌中耐药基因共表达在各类型间无显著性差异(均P>0.05).结论:在非小细胞肺癌组织中存在不同程度的耐药,肺腺癌原发耐药高于肺鳞癌,其耐药是多途径多基因参与的过程.联合检测P-gp、LRP、MRP和GST-π耐药相关基因的表达,对化疗药物的选择及预后的评价具有重要的临床意义.
목적:탐토P-당단백(P-gp)、폐내약단백(LRP)、다약내약상관단백(MRP)화곡광감태전이매(GST-π)재비소세포폐암(NSCLC)중적표체급기림상의의.방법:응용면역조직화학S-P기술대86례치료전비소세포폐암조직표본진행P-gp、LRP、MRP화GST-π표체적검측.결과: LRP화MRP재폐선암、린암중적표체양성솔분별위77.78%、51.22%화80.00%、53.66%;LRP화MRP재불동조직류형중적표체유현저성차이(균P<0.05).P-gp화GST-π재폐선암화린암중적표체양성솔분별위73.33% 、60.98%화80.00%、70.73%;P-gp화GST-π재불동조직류형중적표체무현저성차이(균P>0.05).소측4충내약기인제P-gp외기여3충재중고분화화저분화조간표체양성솔유현저성차이(균P<0.01);4충내약기인재TNM각분기중표체양성솔무현저성차이(균P>0.05).재폐선암화폐린암중동시유2충、3충혹4충내약기인협동표체적양성솔분별위46.67%화34.15%、31.11%화24.39%、20.00%화17.07%,재폐선암화폐린암중내약기인공표체재각류형간무현저성차이(균P>0.05).결론:재비소세포폐암조직중존재불동정도적내약,폐선암원발내약고우폐린암,기내약시다도경다기인삼여적과정.연합검측P-gp、LRP、MRP화GST-π내약상관기인적표체,대화료약물적선택급예후적평개구유중요적림상의의.
Objective:To investigate the expression level and clinical significance of P-gp,LRP,MRP and GST-π in non-small cell lung cancer tissues. Methods: The expression of P-Glycoprotein(P-gp) lung cancer resistance protein(LRP),multidrug resistance protein(MRP) and glutathione S transferases(GST-π) were detected in 86 cases of lung cancer tissues from untreated patients by streptavidin-biotin-peroxidase(S-P) immunohistochemistry technique. Results: The positive rates of LRP and MRP in the adenocarcinoma and squamous carcinoma were 77.78%,51.22% and 80.00%,53.66% respectively.There were statistic difference in LRP and MRP expression in different tissues types(All P<0.05).The positive rates of P-gp and GST-π in the adenocarcinoma and squamous carcinoma were 73.33%,60.98% and 80.00%,70.73% respectively.No significant difference was observed among the positive rates of P-gp and GST-π in different types of lung cancer(All P>0.05).There were statistic difference in the expression positive rates except P-gp in all detected four resistance-related genes between the higher and lower differentiated degree(All P<0.05).No significant difference was observed among the positive rates of four resistance-related genes in different TNM staging of lung cancer(All P>0.05).Two kinds or three kinds or four kinds of resistance-related genes co-expression in the adenocarcinoma and squamous carcinoma tissues were 46.67% and 34.15%,31.11% and 24.39%,20.00% and 17.07% respectively.No significant difference was observed among the co-expression positive rates of various types in the adenocarcinoma and squamous carcinoma tissues(All P>0.05).Conclusion: It has different degree overexpression of resistance-related genes in NSCLC tissues,multidrug resistence in adenocarcinoma was higher than that in squamous carcinoma,MDR of lung cancer is a process involved in polygene and multiple pathways.Combined detection of P-gp,LRP,MRP and GST-π may be useful for guiding the clinical chemotherapy of lung cancer and judgement the prognosis.