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介入治疗对肝细胞癌耐药基因表达的影响 被引量:13

The effect of different interventional treatment on P glycoprotein in different histopathological types of primary hepatocellular carcinoma
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摘要 目的研究不同介入方法对不同组织学类型的原发性肝细胞癌(primaryhepatocelularcarcinoma,PHC)多药耐药(mutidrugresistanceMDR)基因表达蛋白(Pglycoprotein,Pgp)的影响。方法7种不同组织学类型的PHC共98例,单纯手术57例,4种介入方法治疗后Ⅱ期切除41例,采用链霉亲合素生物素酶复合物(streptavidinbiotincomplex,SABC)免疫组化方法,检测各标本中Pgp的含量。结果Pgp阳性百分数,介入A、B、C、D各组和单纯手术组分别为100.0%、62.5%、46.7%、18.2%、52.6%(各介入组与单纯手术组相比,χ2值分别为3.96、0.02、0.17、4.39,P值分别为<0.05、=0.02、>0.5、<0.05)。透明细胞型、梁索型较低,实体型、未分化型较高。从Ⅰ级至Ⅳ级Pgp表达有递增趋势。结论MDR基因过度表达在PHC天然性或获得性耐药起一定作用,且存在组织学差异。无水乙醇碘油乳化剂加明胶海绵联合栓塞可成为克服PHC耐药的新途径。 Objective To study the effect of different interventional treatment on Pgp in different histopathological types of primary hepatocellular carcinoma (PHC). Methods Ninety eight histologically verified PHC specimens were studied. The patients were treated with surgical resection alone (57 cases), second stage surgical resection after four kinds of interventional treatment(41 cases). SABC immunohistochemical staining with a monoclonal antibody against human Pgp was used to observe the Pgp in all specimens. Results Pgp positive rate: 100.0% with chemotherapy alone, 62.5% with chemotherapy combined with iodized oil, 46.7% with chemotherapy combined with iodized oil and spongia gelatini absorbens (Sga), 18.2% with chemotherapy combined with Ethanol、iodized oil and Sga and 52.6% with surgical resection alone (all interventional group compared with surgical group. χ 2 value was 3.96、0.02、0.17、4.39, P value was <0.05、=0.02、>0.5、 <0.05 respetively). The positive rates of Pgp were different in different histopathologlcal types, the clear cell and trabecular PHC were the lowest, whereas the poorly differentiated or undifferentiated PHC was the highest. The positive rates of Pgp increased as pathological grade increased. Conclusions Overexpression of Pgp may be responsible for the intrinsic and acquired drug resistance of PHC. Histological differences exists in multidrug resistance(MDR). Therapy of PHC should be carried by individuation approach. Local chemotherapy combined with ethanol、 iodized oil and Sga embolization may become a new way to overcome MDR of PHC.
出处 《中华放射学杂志》 CAS CSCD 北大核心 1999年第3期150-152,共3页 Chinese Journal of Radiology
基金 国家"九五"攻关项目
关键词 肝细胞癌 介入放射学 P-糖蛋白 基因表达 MDR Carcinoma,hepatocellular Radiology,interventional P glycoprotein Gene expression Immunohistochemistry
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参考文献5

  • 1俞悦 文跃进 等.多药耐药基因MDRI在原发性肝癌组织中表达的意义[J].肝胆外科杂志,1998,6:56-60.
  • 2王学浩,孔连宝,杜竞辉,邢益平,黄祖瑚,李忠佑,王建东.多药耐药基因在人原发性肝细胞癌中的表达[J].普外基础与临床杂志,1996,3(3):129-132. 被引量:4
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