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目的了解胃癌细胞C-erbB-2与多药耐药相关性及其临床意义。方法用流式细胞术检测了59例胃癌手术标本中癌细胞P-糖蛋白(P-gp)和用免疫组化方法检测癌细胞C-erbB-2表达水平,并进行相关性分析。结果胃癌中P-gp表达阳性38／59例(64．4％);C-erbB-2表达阳性21／59例(占35．6％)。胃癌累及范围与P-gp和C-erbB-2表达关系分析发现,在C-erbB-2表达阴性的病例累及2-3个部位的癌比累及一个部位癌的P-gp表达增多,两组比较有显著差异(P= 0．026)。胃癌临床分期与P-gp和C-erbB-2表达比较发现在C-erbB-2阳性时,Ⅲ-Ⅵ期与Ⅰ-Ⅱ期组P-gp表达比较有显著差异(P =0．04)。胃癌分化程度、患者年龄、性别与C-erbB-2和P-gp表达均无相关性。结论在C-erbB-2表达阳性时胃癌临床Ⅲ-Ⅳ期(有淋巴结转移)患者与P-gp表达升高有相关性,提示双阳性时可能肿瘤患者预后较差。但在C-erbB-2表达阴性时胃癌临床分期(有淋巴结转移)与P-gp表达无相关性。
Objective To investigate the correlation between C-erbB-2 and multidrug resistance in gastric cancer cells and its clinical significance. Methods The expression of P-glycoprotein (P-gp) in 59 specimens of gastric cancer and the expression of C-erbB-2 in cancer cells were detected by flow cytometry and their correlations were analyzed. Results The positive expression of P-gp in gastric cancer was 38/59 (64.4%) and 21/59 (35.6%) was positive in C-erbB-2. Analysis of the relationship between the extent of involvement of gastric cancer and the expression of P-gp and C-erbB-2 showed that in patients with negative expression of C-erbB-2, the expression of P-gp in 2-3 parts of cancers was higher than that in one part of cancers. There was a significant difference (P = 0.026). Compared with the clinical stage of gastric cancer and the expression of P-gp and C-erbB-2, the expression of P-gp in stage Ⅲ-Ⅵ and Ⅰ-Ⅱ was significantly different when C-erbB-2 was positive . There was no correlation between the differentiation of gastric cancer, the age of patients and the expression of C-erbB-2 and P-gp. Conclusion The positive expression of C-erbB-2 in gastric cancer patients with stage Ⅲ-Ⅳ (with lymph node metastasis) was correlated with the increased expression of P-gp, suggesting that patients with dual-positive tumors may have a poor prognosis. However, there was no correlation between the clinical stage of gastric cancer (with lymph node metastasis) and the expression of P-gp when the expression of C-erbB-2 was negative.