非小细胞肺癌多药耐药性病理学检测的临床意义

 目的 检测113例非小细胞肺癌（NSCLC）中谷胱甘肽巯基转移酶π（GST-π）、肺耐药相关蛋白（LRP）、DNA拓扑异构酶Ⅱa（TopoⅡa）、多药耐药相关蛋白（MRP）和多药耐药基因（MDRt）的表达，观察上述指标与肿瘤I临床病理因素的关系及各指标表达之间的相关性。方法 采用免疫组化SP法检测GST-π、LRP、TopoⅡa蛋白的表达；应用原位杂交技术检测MRP和MDR1 mRNA表达。结果 （1）GST-π、LRP、TopoⅡa蛋白及MRP、MDR1 mRNA在113例NSCLC中的阳性表达率分别为75.2％、80．5％、60．2％、79．6％、51．3％。其中LRP表达最高，MDR1表达最低。（2）LRP、TopoⅡa和MRP的表达分别与肿瘤组织学类型有关。（3）GST-π与MRP（P〈0．05）、LRP与MRP（P〈0．01）、MDR，与MRP（P〈0．01）的表达间具有相关性。结论 （1）多种耐药相关基因的过度表达及其相互作用可能是NSCLC产生原发MDR的重要原因。（2）LRP和MRP过度表达，TopoⅡa高表达和MRP低表达可能分别与肺腺癌、鳞癌的化疗敏感性有关。

Clinical Significance on Pathological Detection of Multidrug Resistance in Non-small Cell Lung Cancer

Objective 　To evaluate the expressions of GST-π, LRP , Topo Ⅱa , MRP and MDR₁ in 113 non-small cell lung cancer (NSCLC) , to observe their relationships with clinicopathologic characterization of cancer and their interactions. Methods 　Expressions of GST-π, LRP and Topo Ⅱa were detected by S-P immunohistochemistry , and expressions of MRP , MDR₁ mRNA in paraffin-embedded cancer tissues were detected by in situ hybridization. Results 　(1) The positive rates of GST-π, LRP , Topo Ⅱa and MRP , MDR₁ mRNA were 75. 2 % , 80. 5 % , 60. 2 % ,79. 6 % and 51. 3 % in NSCLC , respectively. (2) The expressions of LRP , Topo Ⅱa, MRP had a close relationship with the histological types in NSCLC ,respectively. (3) There were significant relationships between positive rates of GST-π and MRP ( P <0. 05) , LRP and MRP( P < 0. 01) , MDR₁ and MRP ( P < 0. 01) , respectively. Conclusion 　(1) The overexpressions and interactions of GST-π, LRP , Topo Ⅱa , MRP and MDR₁ are important causes of primary MDR in NSCLC. (2) The overexpressions of LRP and MRP , the overexpression of Topo Ⅱa and the reduced expression of MRP , which are related with the chemotherapeutic sensitivity in adenocarcinoma and squamous carcinoma , respectively.