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目的:探讨耐多药基因(ｍｒｄ－１)和耐多药相关蛋白基因(ｍｒｐ)在非小细胞肺癌、癌旁和淋巴结组织中的表达关系及其对患者预后的影响。方法:采用逆转录－聚合酶链反应(ＲＴ－ＰＣＲ)技术,检测了４５例非小细胞肺癌、癌旁和１２５枚手术切除淋巴结组织的ｍｄｒ－１、ｍｒｐ表达。结果:在肺癌组织中ｍｄｒ－１、ｍｒｐ的表达及两基因共表达的阳性率与癌旁组织比较有显著性差异(Ｐ＜０．０１):转移淋巴结(Ｎ１~２)的ｍｄｒ－１、ｍｒｐ阳性率也高于非转移淋巴结组织(Ｎ０)(Ｐ＜０．０１)。随访发现,肺癌组织ｍｄｒ－１和ｍｒｐ阴性患者的术后１、２、３年生存率(８９．５%、７８． ６%和５０%)高于ｍｄｒ－１和ｍｒｐ阳性者(８０．８%、６８．８%和１４．３%)。结论:肺癌组织ｍｄｒ－１、ｍｒｐ的表达与相对应的淋巴结组织具有一致性,转移淋巴结组织的ｍｄｒ－１、ｍｒｐ基因表达可能与临床病理分期有关 ;ｍｄｒ—１和ｍｒｐ阴性者化疗效果好,对于阳性者,术后化疗不能提高远期生存率,而且预后不良。
Objective: To investigate the expression of multidrug resistance gene (mrd-1) and multidrug-associated protein (mrp) in non-small cell lung cancer, paracancerous and lymph node tissues and its effect on patient’s prognosis. Methods: The expression of mdr-1 and mrp in 45 cases of non-small cell lung cancer, para-carcinoma and 125 surgically resected lymph nodes were detected by reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The expression of mdr-1 and mrp in the lung cancer tissues and the positive rate of coexpression between the two genes were significantly different from those in adjacent tissues (P<0.01): mdr-1 in metastatic lymph nodes (N1~2). The positive rate of mrp was also higher than that of non-metastatic lymph node tissues (N0) (P<0.01). After follow-up, the 1-, 2-, and 3-year survival rates (89.5%, 78.6%, and 50%) in patients with mdr-1 and mrp-negative lung cancer were higher than those with positive mdr-1 and mrp (80.8). %, 68.8% and 14.3%). Conclusion: The expressions of mdr-1 and mrp in lung cancer tissues are consistent with the corresponding lymph node tissues. The expression of mdr-1 and mrp genes in metastatic lymph node tissues may be related to clinical pathological staging. The chemotherapy effects of mdr-1 and mrp negative are good. For those who are positive, postoperative chemotherapy does not improve long-term survival and has a poor prognosis.