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目的探讨老年患者胃癌肿瘤组织的体外化疗药物敏感性与凋亡抑制蛋白表达的关系。方法 MTT法检测65例老年胃癌患者(≥65岁)及58例对照组患者(<65岁)肿瘤细胞原代培养药物敏感性。应用免疫组化法检测肿瘤组织凋亡抑制蛋白p53、生存素和Bcl-2的表达。结果10种化疗药物中,氟尿嘧啶(5-FU)、长春新碱(VCR)、奥沙利铂(L-OHP)、表阿霉素(eADM)、丝裂霉素(MMC)对老年患者肿瘤细胞的抑制率低于对照组(P<0.05)。老年组生存素、Bcl-2表达高于对照组(P<0.01),且两者表达存在正相关性(P<0.05);对照组p53的表达与Bcl-2存在正相关(P<0.01)。老年胃癌患者p53的表达与紫杉醇(PTX)、顺铂(CDDP)对肿瘤细胞的抑制率呈负相关(P<0.01),生存素与5-FU、PTX、L-OHP、CDDP、eADM的抑制率呈负相关(P<0.05),Bcl-2表达则与VCR、足叶乙甙(VP-16)、羟基喜树碱(HCPT)、PTX、吡喃阿霉素(THP)呈负相关(P<0.05);对照组p53与CDDP的抑制率呈负相关(P<0.05),生存素表达则与5-FU、VCR、HCPT呈负相(P<0.01),Bcl-2表达与VP-16、CDDP对肿瘤细胞的抑制率呈负相关(P<0.05),但与L-OHP的抑制率正相关(P<0.05)。结论老年胃癌患者与对照组存在不同的多药耐药表型,凋亡抑制蛋白在老年胃癌多药耐药中起重要作用。
Objective To investigate the relationship between chemosensitivity and expression of apoptosis-inhibitor protein in gastric cancer tissue in elderly patients. Methods MTT assay was used to detect the drug sensitivity of 65 primary gastric cancer patients (≥65 years old) and 58 control patients (<65 years old). Immunohistochemistry was used to detect the expression of p53, survivin and Bcl-2 in tumor tissues. Results Among the 10 chemotherapeutic drugs, 5-fluorouracil (5-FU), vincristine (VCR), oxaliplatin (L-OHP), epirubicin (eADM) and mitomycin (MMC) The inhibition rate of cells was lower than that of the control group (P <0.05). The expression of Bcl-2 and survivin in the elderly group was higher than that in the control group (P <0.01), and there was a positive correlation between the expression of Bcl-2 and the expression of Bcl-2 in the control group (P <0.01) . The expression of p53 in elderly patients with gastric cancer was negatively correlated with the inhibition rate of tumor cells by paclitaxel (PTX) and cisplatin (CDDP), and the inhibition of survivin with 5-FU, PTX, L-OHP, CDDP and eADM (P <0.05). The expression of Bcl-2 was negatively correlated with VCR, VP-16, HCPT, PTX, and pirarubicin P <0.05). The inhibitory rates of p53 and CDDP in the control group were negatively correlated (P <0.05), and the expression of survivin was negatively correlated with 5-FU, VCR and HCPT (P <0.01) 16, CDDP had a negative correlation with tumor cell inhibitory rate (P <0.05), but positively correlated with the inhibitory rate of L-OHP (P <0.05). Conclusion There are different multidrug resistance phenotypes in elderly patients with gastric cancer and control group, and apoptosis inhibitory protein plays an important role in multidrug resistance of elderly gastric cancer.