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目的 研究多药耐药基因mdr1编码P 糖蛋白 (Pgp)和mRNA在原发性胆囊癌组织中的表达 ,分析其临床意义。方法 采用S P免疫组织化学方法和原位多聚酶链反应 (PCR)对 53例未化疗原发性胆囊癌和 1 2例胆囊炎存档石蜡包埋切片组织中Pgp、mdrlmRNA的表达进行检测。结果 53例胆囊癌、1 2例胆囊炎组织中Pgp和mdrlmRNA阳性表达率分别为 60 .38%、71 .69%和 2 5 .0 0 %、33 .33 %。两组mdrl基因表达差异有显著性 (P <0 .0 5)。胆囊癌组织中的Pgp和mdrlmRNA阳性率在胆囊癌Nevin分期Ⅰ、Ⅱ、Ⅲ期中为 69.44%和 83 .33 % ,Ⅳ、Ⅴ期为41 .1 8%和 47.0 6 % ;高、中分化为 69.2 3 %和 79.49% ,低、未分化为 35 .71 %和 50 .0 0 %。胆囊癌Nevin分期Ⅰ～Ⅲ和高中分化mdrl基因表达明显高于Nevin分期Ⅳ、Ⅴ及低未分化胆囊癌组织 (P<0 .0 5)。结论 胆囊癌多药耐药性与其内源性耐药密切相关 ,检测mdrl基因为逆转耐药提供依据。mdrl基因表达与胆囊癌部分生物学特性相关 ,mdrl基因可能参与癌肿的发生 ,mdrl基因有望作为胆囊癌独立预后的生物学指标
Objective To study the expression of multidrug resistance gene mdr1 encoding P-glycoprotein (Pgp) and mRNA in primary gallbladder carcinoma and to analyze its clinical significance. Methods The expression of Pgp and mdrl mRNA in paraffin-embedded sections of 53 cases with primary gallbladder carcinoma and 12 cases with cholecystitis were detected by SP immunohistochemistry and in situ polymerase chain reaction (PCR). Results The positive rates of Pgp and mdrl mRNA in 53 gallbladder carcinomas and 12 cholecystitis tissues were 60.38%, 71.69% and 25.5%, 33.33%, respectively. There was a significant difference in mdrl gene expression between the two groups (P <0.05). The positive rates of Pgp and mdrl mRNA in gallbladder cancer tissues were 69.44% and 83.33% in stages Ⅰ, Ⅱ and Ⅲ of gallbladder carcinoma, 41.1% and 47.0% in stages Ⅳ and Ⅴ, respectively 69.2 3% and 79.49%, low, undifferentiated to 35.71% and 50.0%. The expression of mdrl gene in gallbladder neoplasms Ⅰ ~ Ⅲ and high differentiated gallbladder carcinoma was significantly higher than that in Nevin staging Ⅳ, Ⅴ and low undifferentiated gallbladder carcinoma (P <0.05). Conclusion The multidrug resistance of gallbladder carcinoma is closely related to its endogenous resistance. Detecting mdrl gene may provide a basis for reversing drug resistance. mdrl gene expression and some biological characteristics of gallbladder cancer, mdrl gene may be involved in the occurrence of cancer, mdrl gene is expected as an independent prognostic indicator of gallbladder cancer biological indicators