P-糖蛋白表达与原发性肝癌合并门静脉癌栓患者术后辅助化疗效果的相关性研究-论文.pdf

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1、中华普通外科学文献(电子版)2013年10月第7卷第5期ChinArchGenSurg(ElectronicEdition)，October2013，Vo1．7，No．5·论著·P一糖蛋白表达与原发性肝癌合并门静脉癌栓患者术后辅助化疗效果的相关性研究胡文杰黎东明陈伟张昆松黄力梁力建【摘要】目的研究P一糖蛋白(P—gP)表达与原发性肝细胞癌合并门静脉癌栓患者表达情况与临床化疗效果之间的关系。方法收集术后接受化疗的29例原发性肝细胞癌合并门静脉癌栓患者的石蜡块，构建组织芯片。采用免疫组化染色技术，检测

2、P—g1)蛋白的表达情况。根据P—gp蛋白表达强弱分为耐药组和非耐药组，进行生存分析。结果P—gP蛋白表达的阳性率为75．86％(22／29)。中位无瘤生存期在耐药组(20例)与非耐药组(9例)间有显著差别。多因素Cox回归分析显示P—gf)表达情况为无瘤生存期的独立影响因子。结论P—gP的强表达是导致肝癌耐药、化疗效果欠佳的原因之一，P—gP有可能作为临床筛选化疗患者的指标。【关键词】P一糖蛋白；肝细胞癌；癌栓；门静脉；化疗CorrelationbetweentheexpressionofP-g

3、pandefficacyofchemotherapypostoperationinhepatoceUularcarcinomapatientswithtumorthrombiinmajorportalveinHUWen--jie,LIDong——Ming，CHENWei，ZHANGKun—song，HUANGLi，L1ANGLi-jian．DepartmentofHepatobilliarySurgery，theFirstAfiliatedHospitalofSunYat—senUniversit

4、y，Guangzhou510080，ChinaCorrespondingauthor：LIANGLi-jian，Email：lianglj@medmail．corn．cn【Abstract】ObjectiveToinvestigatetheexpressionofp-glycoprotein(P—gp)anditscorrelationtochemotherapeuticeficacyinhepatocellularcarcinoma(HCC)withtumorthrombiinmajorport

5、alvein．MethodsTwenty-ninepatientsofHCCwithtumorthrombiinmajorportalveinfollowinghepatectomyandthrombectomywereenrolledinthisstudy，allthepatientsreceivedimmunochemotherapypostperatively．Specimensembeddedinparaffinwerecollectedfortheconstructionoftissue

6、microarrays．P—gPproteinwerevisualizedbyimmunohistochemicalstainingusingMonoclonalantibodiesJSB-1．Thepatientsweredividedintochemotherapysensitiveandresistantgroupsaccordingtothestaininggrade．Theintensity≥f++)wereconsideredresistanttochemotherapy．Surviv

7、altimeWaScomparedbetweenthetwogroupsandprognosticfactorswereidentifiedusingCoxproportionalhazardsmode1．ResultsThepositiverateofP—gPwas75．86％f22／29)．Mediumtumor—freesurvivaltimeshowedsignificantdifferencesbetweentwogroups．Multivariateanalysisrevealedth

8、attheexpressiongradeofP-gpwasindependentprognosticfactorfortumor—freesurvivaltime．ConclusionInHCCwithtumorthrombiinmajorportalvein，theoverexpressionofP-gpisoneofthemajorreasonforresistancetochemotherapy，detectionofwhichwillbehelpfulinchemother