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目的 :探讨贲门癌组织中多药耐药基因 (MDR1)表达与其病理特征的关系。方法 :应用逆转录多聚酶链反应 (RT PCR)方法 ,对 5 1例贲门癌组织、癌旁及 35枚淋巴结中MDR1基因的表达进行检测分析。结果 :贲门癌组织中MDR1阳性 18例(35 3% ) ,癌旁组织MDR1阳性 2例 (3 9% ) ,两者比较差异具有显著性 (P <0 0 5 )。 2 1枚转移淋巴结组织MDR1阳性 6例(2 8 6 % ) ,14枚非转移淋巴结中未见MDR1阳性表达 ;MDR1表达阳性与肿瘤大小、浸润程度、病理分期及淋巴转移与否虽无统计学意义 ,但在TNMⅢ、Ⅳ期和肿瘤侵犯深肌层以上的MDR1基因表达阳性率增高 ;低分化贲门癌的MDR1阳性分布明显高于高分化肿瘤 (P <0 0 5 )。对部分病例随访发现 ,MDR1阳性者肿瘤复发与转移的总发生率 (46 2 % )高于MDR1阴性者(2 1 1% )。结论 :贲门癌组织中存在着原发性MDR1基因表达 ,并与转移淋巴结组织的MDR1基因表达具有一致性 ,MDR1的表达除了表现肿瘤的多药耐药外 ,还可能是贲门癌恶性行为的观察指标 ,提示预后不良。
Objective: To investigate the relationship between multidrug resistance gene (MDR1) expression and pathological features in cardiac cancer. Methods: The expression of MDR1 gene in 51 cases of gastric cardia carcinoma, adjacent tissues and 35 lymph nodes was detected by reverse transcriptase polymerase chain reaction (RT PCR). Results: There were 18 cases (35.3%) positive for MDR1 and 2 cases (3 9%) for MDR1 in paracancerous tissues, the difference was significant (P <0.05). There were 6 positive cases (286%) of MDR1 in 1 lymph node metastasis and no positive expression of MDR1 in 14 non-metastatic lymph nodes. The positive expression of MDR1 correlated with tumor size, degree of infiltration, pathological stage and lymphatic metastasis However, the positive rate of MDR1 gene expression was higher in TNMⅢ, Ⅳ and tumor invasion deep myometrium. The positive distribution of MDR1 in poorly differentiated cardia carcinoma was significantly higher than that in well differentiated tumors (P <0.05). Follow-up in some cases found that the overall incidence of tumor recurrence and metastasis (46 2%) was higher in MDR1-positive than in MDR1-negative (21.1%). Conclusion: The primary MDR1 gene expression exists in gastric cardia carcinoma and is consistent with the expression of MDR1 gene in metastatic lymph nodes. The expression of MDR1 may be not only the multidrug resistance of tumor, but also the observation of the malignant behavior of cardia carcinoma Indicators, suggesting a poor prognosis.