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耐药相关基因在卵巢癌组织中的表达及其临床意义 |
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, the positive expression of MDR1 was 0.0%, 0.0% and 29.3%, the positive of MRP was 16.7%、12.0% and 53.7%, the positive of LRP was 25.0%、52.0% and 87.8%, the positive of GST-π was 8.3%、12.0% and 51.2% respectively. The ratios of co-expression of multiple genes in ovarian cancer were much higher than that in benign ovarian tumor. All tested genes showed no significant relationship to the clinical stage, histological type and the differentiation of the tumor except that the expression of MDR1 and MRP was closely related to the differentiation (P<0.05). The non-responders to platinum or taxol based combination chemotherapy exhibited higher ratios of MDR1 and MRP expression than the responders (P<0.05). Furthermore, the co-expression phenomenon was more common in non-responders. Conclusions Multiple gene expression is involved in drug resistance in ovarian cancer. The co-expression of MDR1, MRP, LRP and GST-πis higher in ovarian cancer than that in benign ovarian tumor and normal ovary tissue. The expression of MDR1 and MRP is closely related to the tumor differentiation and the response to chemotherapy.
Key words：Ovarian neoplasms； Genes, MDR； Multidrug resistance associated protein； Glutathione transferases▲
对化学治疗（化疗）耐药是卵巢癌治疗失败的主要原因之一。国内外研究表明，肿瘤耐药涉及细胞内药物浓度降低、药物靶分子改变、代谢解毒、DNA损伤修复功能增强等多种机理，与多种耐药相关基因有关［1］。本研究采用定量逆转录-聚合酶链反应(RT-PCR)，同时测定了多药耐药基因（MDR1）、多药耐药相关蛋白（MRP）、肺耐药相关蛋白（LRP）和谷胱甘肽S-转移酶（GST-π）等多个耐药相关基因在卵巢肿瘤组织中的表达, 以了解其意义。
资料与方法
一、研究对象
选自1995年1月至1997年12月间，在解放军总医院妇产科住院进行手术治疗的患者共78例，其标本均经病理检查证实。其中卵巢良性肿瘤25例；卵巢癌41例；另取正常卵巢12例（因妇科良性疾病手术切除）作为对照。卵巢良性肿瘤包括浆液性上皮瘤10例，粘液性上皮瘤7例，成熟畸胎瘤6例，良性Berner瘤1例，卵巢冠囊肿1例。卵巢癌包括浆液性乳头状囊腺癌（浆液癌）20例，粘液性乳头状囊腺癌（粘液癌）5例，透明细胞癌7例，子宫内膜样癌2例，未分化腺癌6例，内胚窦瘤1例。其中，临床Ⅰ期3例，Ⅱ期5例，Ⅲ期30例，Ⅳ期3例，36例在术后1周内开始化疗，共接受了6～13个疗程的化疗，方案以PAC（顺铂，阿霉素，环磷酰胺）或泰素加PC（顺铂，环磷酰胺）方案为主。
二、方法
1．标本收集：手术切除后1 h内，将标本置于液氮保存。所有病例在手术前均未接受化疗。
2.引物设计：根据从Genbank中查到的各基因序列设计聚合酶链反应（PCR）引物，分别为MDR1：5′GTACCCATCATTGCAATAGC3&上一页 [1] [2] [3] 下一页
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