中华普通外科学文献（电子版）
中華普通外科學文獻（電子版）
중화보통외과학문헌（전자판）
CHINESE JOURNAL OF GENERAL SURGERY(ELECTRONIC VERSION)
2014年
5期
376-380
,共5页
胡文杰%黎东明%陈伟%张昆松%黄力%梁力建
鬍文傑%黎東明%陳偉%張昆鬆%黃力%樑力建
호문걸%려동명%진위%장곤송%황력%량력건
多药耐药相关蛋白%肝细胞癌%癌栓%门静脉%化疗
多藥耐藥相關蛋白%肝細胞癌%癌栓%門靜脈%化療
다약내약상관단백%간세포암%암전%문정맥%화료
Multidrug resistance-associated protein%Hepatocellular carcinoma%Tumor thrombi%Portal vein%Chemotherapy
目的：研究多药耐药相关蛋白2、3（MRP2、MRP3）表达与原发性肝细胞癌（HCC）合并门静脉癌栓患者术后辅助化疗疗效的相关性。方法收集2001年1月至2005年12月术后接受化疗的29例HCC合并门静脉癌栓患者的石蜡标本，构建组织芯片。采用免疫组织化学染色技术检测MRP2、MRP3的表达情况。将蛋白表达强度（++）以上设为耐药组，其余为非耐药组，结合临床资料进行生存分析。结果 MRP2、MRP3阳性表达率分别为86.21％（25/29）和62.07％（18/29）。依据MRP2表达情况，耐药组19例和非耐药组10例进行生存分析显示，总体生存期（P=0.010）及无瘤生存期（P=0.039）差异有统计学意义。依据MRP3表达情况，耐药组16例和非耐药组13例比较，仅无瘤生存期差异有统计学意义（P=0.043）。多因素Cox回归分析显示，MRP2（P=0.009， HR=4.897，95%CI=1.475~16.261）、MRP3（P=0.002，HR=5.515，95%CI=1.861~16.341）表达情况为无瘤生存的独立影响因子。结论 MRP2、MRP3的强表达是导致肝癌耐药及化疗效果欠佳的原因之一。MRP2、MRP3有可能作为原发性肝癌患者临床筛选化疗方案的指标。
目的：研究多藥耐藥相關蛋白2、3（MRP2、MRP3）錶達與原髮性肝細胞癌（HCC）閤併門靜脈癌栓患者術後輔助化療療效的相關性。方法收集2001年1月至2005年12月術後接受化療的29例HCC閤併門靜脈癌栓患者的石蠟標本，構建組織芯片。採用免疫組織化學染色技術檢測MRP2、MRP3的錶達情況。將蛋白錶達彊度（++）以上設為耐藥組，其餘為非耐藥組，結閤臨床資料進行生存分析。結果 MRP2、MRP3暘性錶達率分彆為86.21％（25/29）和62.07％（18/29）。依據MRP2錶達情況，耐藥組19例和非耐藥組10例進行生存分析顯示，總體生存期（P=0.010）及無瘤生存期（P=0.039）差異有統計學意義。依據MRP3錶達情況，耐藥組16例和非耐藥組13例比較，僅無瘤生存期差異有統計學意義（P=0.043）。多因素Cox迴歸分析顯示，MRP2（P=0.009， HR=4.897，95%CI=1.475~16.261）、MRP3（P=0.002，HR=5.515，95%CI=1.861~16.341）錶達情況為無瘤生存的獨立影響因子。結論 MRP2、MRP3的彊錶達是導緻肝癌耐藥及化療效果欠佳的原因之一。MRP2、MRP3有可能作為原髮性肝癌患者臨床篩選化療方案的指標。
목적：연구다약내약상관단백2、3（MRP2、MRP3）표체여원발성간세포암（HCC）합병문정맥암전환자술후보조화료료효적상관성。방법수집2001년1월지2005년12월술후접수화료적29례HCC합병문정맥암전환자적석사표본，구건조직심편。채용면역조직화학염색기술검측MRP2、MRP3적표체정황。장단백표체강도（++）이상설위내약조，기여위비내약조，결합림상자료진행생존분석。결과 MRP2、MRP3양성표체솔분별위86.21％（25/29）화62.07％（18/29）。의거MRP2표체정황，내약조19례화비내약조10례진행생존분석현시，총체생존기（P=0.010）급무류생존기（P=0.039）차이유통계학의의。의거MRP3표체정황，내약조16례화비내약조13례비교，부무류생존기차이유통계학의의（P=0.043）。다인소Cox회귀분석현시，MRP2（P=0.009， HR=4.897，95%CI=1.475~16.261）、MRP3（P=0.002，HR=5.515，95%CI=1.861~16.341）표체정황위무류생존적독립영향인자。결론 MRP2、MRP3적강표체시도치간암내약급화료효과흠가적원인지일。MRP2、MRP3유가능작위원발성간암환자림상사선화료방안적지표。
Objective To investigate the expression of multidrug resistance-associated proteins (MRP2, MRP3) and their correlation to chemotherapeutic efficacy in hepatocellular carcinoma (HCC) with tumor thrombi in major portal vein. Methods Twenty-nine HCC patients with tumor thrombi in major portal vein following hepatectomy, thrombectomy and postoperative adjuvantchemotherapy were enrolled in this study. Specimens embedded in paraffin were collected for the construction of tissue microarrays. MRP2 and MRP3 were visualized by immunohistochemical staining. The patients were divided into chemotherapy sensitive and resistant groups according to the staining grade. The intensity≥(++) were considered resistant to chemotherapy. Survival time was compared between the two groups and prognostic factors were identified using Cox proportional hazards model. Results The positive rate of MRP2 and MRP3 was 86.21%, 62.07%, respectively. Tumor-free survival time and overall survival time were significantly different between the two groups according to the staining grade of MRP2 (P=0.039, 0.010, respectively). Only tumor-free survival time was significantly different according to the staining grade of MRP3 (P=0.043). Multivariate analysis revealed that the expression grade of MRP2 and MRP3 was independent prognostic factor for tumor-free survival time (P=0.009, 0.002, respectively). Conculsion In HCC patients with tumor thrombi in major portal vein, the overexpression of MRP2, MRP3 is one of the major reasons for resistance to chemotherapy. Detection of MRP2 and MRP3 will be helpful in chemotherapy decision making.
