摘要
目的检测人体胃癌组织中耐药基因的表达情况,并根据检测结果选用相应的敏感药物化疗,探讨耐药基因检测对胃癌临床化疗的指导意义。方法将80例经胃镜检查及病理证实为胃癌的患者,根据编号预先随机分为适配组和非适配组2组,每组40人。应用免疫组织化学方法检测所有病例胃癌组织中P-gp、GST-π、Topo-Ⅱ的表达情况。适配组患者根据检测结果选用相应的敏感药物适配化疗,非适配组统一选用FOLFOX4方案化疗。结果P-gp、GST-π、Topo-Ⅱ表达率分别为51.5%、57.5%、46.3%;P-gp、TopoⅡ的表达与肿瘤分化程度有关,P-gp高中分化者表达率高于其他非高中分化者,TopoⅡ高中分化者表达率低于其他非高中分化者;GST-π的表达与分化程度无关,高中分化者与非高中分化者无显著差异。适配组化疗有效率为57.5%,非适配组有效率为35%,两组比较差异有统计学意义(P<0.05)。结论P-gp、GST-π、Topo-Ⅱ的耐药机制各不相同,根据耐药基因的检测结果针对不同患者,实施科学的、药物适配的个体化化疗方案对胃癌治疗具有重要的指导意义,可以提高化疗效果。
Objective To test the expressions of multiple drug resistance （MDR） gene of human gastric carcinoma, and investigate its significance in guiding gastric carcinoma clinical chemotherapy by choosing appropriate remedy according to examination result. Methods Eighty gastric cancer patients diagnosed by endoscopy and pahology were random divided into two groups （fit group and non-fit group）, each included 40 patients. The expression of P-gp,GST-π,Topo-Ⅱ was tested in 80 gastric cancer specimen using immunohistochemistry. The fit group patients were treated by choosing sensitive chemical remedy fitting for gene examination result. The nonfit group patients were treated with the experiential chemotherapeutic scheme of FOLFOX4. Results Positive expression rates of P-gp,GST-π,Topo-Ⅱ in 80 cases of gastric cancer were 51.5 %,57. 5 %,46. 3 %, respectively. There were some correlations between the positive expression of P-gp,Topo-Ⅱ and the degree of tumor dif ferentiation,which was higher in well differentiated tumor than that in poor differentiated one for P-gp, but it was reverse for Topo-Ⅱ There were no correlations between the positive expression of GST-π and the degree of tumor differentiation. The response rate was 57. 50% in the fit group, which was 35% in the non-fit group. There were significant different between the two groups （P〈0. 05）. Conclusion The mechanisms of drug resistance of P-gp, GST-π, Topo-Ⅱ in gastric cancer are different. It is of significance for guiding gastric cancer clinical therapy by applying the different, sensitive, scientific individual chemotherapy according to the detection results of drug resistance gene, and is helpful to achieve better chemotherapy efficacy for gastric cancer patients.
出处
《肿瘤防治研究》
CAS
CSCD
北大核心
2008年第10期711-714,共4页
Cancer Research on Prevention and Treatment
