目的 探讨胃腺癌中多药耐药基因蛋白P-gp(P-glycoprotein,P-gp)、ToPoⅡ(topoisomerase ToPoⅡ)、GSTπ(glutathione-S-transferase,GSTπ)、MGMT(O6-methylguanine-DNA-methyltransferase,MGMT)和TS(thymidylate synthase,TS)的表达情况及临床意义.方法 采用免疫组化SP法对74例原发性胃腺癌组织与10例癌旁正常胃黏膜组织中P-gp、ToPoⅡ、GSTπ、MGMT和TS的表达进行检测,并结合其临床病理资料进行综合分析.结果 74例胃腺癌中P-gp、ToPoⅡ、GSTπ、MGMT和TS的阳性率分别为37.8%、63.5%、63.5%、78.4%和10.8%;5种蛋白在10例正常胃黏膜组织中的阳性率分别为20.0%、0、30.0%、40.0%和0.ToPoⅡ、GSTπ和MGMT在胃腺癌组的阳性率明显高于正常组(ToPoⅡ:P＜0.01,GSTπ:P＜0.05,MGMT:P＜0.05).P-gp的表达与临床分期和脉管内有无癌栓相关(P＜0.05,P＜0.01);GSTπ的表达与侵犯深度相关(P＜0.01);TS的表达与淋巴结有无转移相关(P＜0.01).结论 ToPoⅡ、GSTπ和MGMT在胃腺癌中过表达与胃腺癌多药耐药相关,P-gp、GSTπ和TS与胃腺癌的侵袭性和预后有一定关系.P-gp、ToPoⅡ、GSTπ、MGMT和TS的联合检测对化疗药的筛选有重要的指导意义.%Purpose To investigate the expressions of multidrug resistance gene products P-gp,ToPo Ⅱ ,GSTπ,MGMT and TS in gastric adenocarcinoma and analyze their clinical significances. Methods SP immunohistochemical stain was used to detect their expressions in sample of 74 primary gastric cancer tissues and 10 normal gastric mucosa near the tumor. And their corresponding clinical data were comprehensive analyzed. Results The positive expression rates of P-gp, Topo- Ⅱ , GST-π, MGMT and TS were 37. 8% , 63. 5% , 63. 5% , 78. 4% and 10. 8% in gastric carcinoma and were 20. 0% , 0, 30. 0% , 40. 0% and 0 in normal tissues. ToPoⅡ,GSTπ and MGMT had notable differences between the gastric cancer tissues and normal gastric mucosa ( ToPo Ⅱ :P<0. 01, GSTπ :P <0. 05,MGMT :P <0. 05 ). The expression of P-gp was closely relevant to the clinical stage and vessel carcinoma embolus ( P < 0. 05 and P < 0. 01 ). The expression of GSTπ was closely relevant to the invasive depth ( P < 0. 01 ). The expression of TS was corelated to the lymph node metastasis( P <0. 01 ). Conclusions ToPoⅡ ,GSTπ and MGMT is over-expressed in gastric carcinoma, which is related to the multidrug resistance of gastric carcinoma. P-gp, GSTπ and TS is related to the invasion and prognosis of gastric carcinoma. The joint detection of P-gp, ToPoⅡ , GSTπ , MGMT and TS can be looked as an important symbol for guiding its chemotherapy.
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