西安交通大学学报（医学版）
西安交通大學學報（醫學版）
서안교통대학학보（의학판）
JOURNAL OF XI'AN JIAOTONG UNIVERSITY(MEDICAL SCIENCES)
2015年
3期
414-417,426
,共5页
吴照宇%郭应兴%雷进元%于海东
吳照宇%郭應興%雷進元%于海東
오조우%곽응흥%뢰진원%우해동
原发性肝癌%肝动脉插管栓塞化疗(TACE)%多药耐药%MDR1%P-gp%生存率
原髮性肝癌%肝動脈插管栓塞化療(TACE)%多藥耐藥%MDR1%P-gp%生存率
원발성간암%간동맥삽관전새화료(TACE)%다약내약%MDR1%P-gp%생존솔
primary liver cancer%transcatheter arterial embolization chemotherapy (TACE)%multidrug resist-ance%MDR1%P-gp%survival rate
目的：检测肝癌细胞的多药耐药基因 MDR1及编码产物 P-gp(P-glycoprotein,P-gp)的表达并探讨其与原发性肝癌经肝动脉插管栓塞化疗(transcatheter arterial chemoembolization,TACE)疗效的关系及临床意义。方法选取2010年6月到2013年6月来我院接受手术治疗的108例原发性肝癌患者作为肝癌组研究对象,同时选取来我院行肝穿刺检查的50例健康者作为对照。采用实时荧光定量 PCR 测定各组肝组织中 MDR1的 mRNA 水平,并采用免疫组织化学法检测手术切除后的肝癌组织 P-gp 的表达。根据 P-gp 表达水平将患者分为耐药组和非耐药组,分析 P-gp 表达水平与原发性肝癌术后 TACE 治疗效果的关系。结果与对照组比较,肝癌组患者肝脏组织中 MDR1的 mRNA表达水平显著升高(P <0.05)。其中肝癌组 MDR1的 mRNA/正常水平>2的患者76例,MDR1的 mRNA/正常水平<2的患者32例。免疫组织化学结果显示 P-gp 呈棕黄色,主要表达于肝癌细胞的细胞膜表面。其中 P-gp 蛋白阴性患者(非耐药组)35例,阳性患者(耐药组)73例。非耐药组患者化疗有效率(74.28%)明显高于耐药组患者(43.28%)(P <0.05)。非耐药组1、2年累积生存率为77.14%和42.86%,明显高于耐药组(54.12%和27.40%,P <0.05)。结论原发性肝癌组织中 MDR1编码产物 P-gp 异常过表达与肿瘤化疗耐药性相关,提示其可作为临床术后化疗用药的指导标志之一。
目的：檢測肝癌細胞的多藥耐藥基因 MDR1及編碼產物 P-gp(P-glycoprotein,P-gp)的錶達併探討其與原髮性肝癌經肝動脈插管栓塞化療(transcatheter arterial chemoembolization,TACE)療效的關繫及臨床意義。方法選取2010年6月到2013年6月來我院接受手術治療的108例原髮性肝癌患者作為肝癌組研究對象,同時選取來我院行肝穿刺檢查的50例健康者作為對照。採用實時熒光定量 PCR 測定各組肝組織中 MDR1的 mRNA 水平,併採用免疫組織化學法檢測手術切除後的肝癌組織 P-gp 的錶達。根據 P-gp 錶達水平將患者分為耐藥組和非耐藥組,分析 P-gp 錶達水平與原髮性肝癌術後 TACE 治療效果的關繫。結果與對照組比較,肝癌組患者肝髒組織中 MDR1的 mRNA錶達水平顯著升高(P <0.05)。其中肝癌組 MDR1的 mRNA/正常水平>2的患者76例,MDR1的 mRNA/正常水平<2的患者32例。免疫組織化學結果顯示 P-gp 呈棕黃色,主要錶達于肝癌細胞的細胞膜錶麵。其中 P-gp 蛋白陰性患者(非耐藥組)35例,暘性患者(耐藥組)73例。非耐藥組患者化療有效率(74.28%)明顯高于耐藥組患者(43.28%)(P <0.05)。非耐藥組1、2年纍積生存率為77.14%和42.86%,明顯高于耐藥組(54.12%和27.40%,P <0.05)。結論原髮性肝癌組織中 MDR1編碼產物 P-gp 異常過錶達與腫瘤化療耐藥性相關,提示其可作為臨床術後化療用藥的指導標誌之一。
목적：검측간암세포적다약내약기인 MDR1급편마산물 P-gp(P-glycoprotein,P-gp)적표체병탐토기여원발성간암경간동맥삽관전새화료(transcatheter arterial chemoembolization,TACE)료효적관계급림상의의。방법선취2010년6월도2013년6월래아원접수수술치료적108례원발성간암환자작위간암조연구대상,동시선취래아원행간천자검사적50례건강자작위대조。채용실시형광정량 PCR 측정각조간조직중 MDR1적 mRNA 수평,병채용면역조직화학법검측수술절제후적간암조직 P-gp 적표체。근거 P-gp 표체수평장환자분위내약조화비내약조,분석 P-gp 표체수평여원발성간암술후 TACE 치료효과적관계。결과여대조조비교,간암조환자간장조직중 MDR1적 mRNA표체수평현저승고(P <0.05)。기중간암조 MDR1적 mRNA/정상수평>2적환자76례,MDR1적 mRNA/정상수평<2적환자32례。면역조직화학결과현시 P-gp 정종황색,주요표체우간암세포적세포막표면。기중 P-gp 단백음성환자(비내약조)35례,양성환자(내약조)73례。비내약조환자화료유효솔(74.28%)명현고우내약조환자(43.28%)(P <0.05)。비내약조1、2년루적생존솔위77.14%화42.86%,명현고우내약조(54.12%화27.40%,P <0.05)。결론원발성간암조직중 MDR1편마산물 P-gp 이상과표체여종류화료내약성상관,제시기가작위림상술후화료용약적지도표지지일。
Objective To explore the relationship of MDR1 and its encoded product P-gp expressions with clinical efficacy of transcatheter arterial chemoembolization (TACE)in primary liver cancer and their clinical significance.Methods We selected 108 patients with primary liver cancer who came to our hospital between June 2010 and June 2013 as observation subjects.Meanwhile 50 healthy people in our hospital for liver biopsy were selected as controls.MDR1 mRNA level in observation group and control group was determined by real-time quantitative PCR.P-gp protein level was analyzed by immunohistochemistry.According to P-gp level,the 108 patients were divided into drug-resistance groups and non-resistance group;the relationship between P-gp expression level and clinical efficacy was analyzed.Results MDR1 mRNA level in liver tissues significantly enhanced in observation group compared with that in control group (P <0.05).In observation group 32 patients had the ratio of MDR1 mRNA level-normal level of more than 2 and 76 patients had the ratio of MDR1 mRNA level-normal level of less than 2. Immunohistochemistry revealed that MDR1 encoded product P-gp was brownish yellow, mainly expressed in the cell surface of liver cancer cells.There were 35 P-gp protein-negative patients (non-resistance group)and 73 positive patients (resistance group).Clinical efficacy was significantly higher in non-resistance group (74.28%)than in resistance group (43.28%)(P <0.05).The 1 year and 2-year cumulative survival rates were 54. 12% and 27.40% in resistance group and 77.14% and 42.86%% in non-resistance group.They were significantly higher in the latter group (P <0.05 ).Conclusion The overexpressed MDR1 encoded product P-gp in primary liver cancer is associated with multidrug resistance in tumor chemotherapy,suggesting that P-gp can be used as one of the guiding clinical markers of chemotherapy.
