【摘要】 目的:探讨肺癌成纤维细胞P-gp（P-glycoprotein,P170）的表达水平在肺癌逃避免疫和耐药性的机制及对患者预后的影响。方法:回顾性分析本院胸外科2003年1月到2007年5月诊断为肺癌并能够获得完整随访资料的78例患者,应用Max Vision^TM快捷免疫组化染色所选标本,观察NSCLC组织中成纤维细胞（TAF）及非癌肺组织中TAF细胞中的P-gp的表达,采用X²检验及fisher确切概率法,多个独立样本的比较采用检验Kruskal-Walis H分析,相关分析采用Spearman等级相关分析,Kaplan-Meier生存曲线计算患者生存率。结果:在78例NSCLC患者中,P-gp的表达与患者年龄、肿瘤分化程度、临床分期,有无淋巴结转移有关（P<0.05）,NSCLC患者中P-gp阳性者术后无进展生存率（PFS）术后总生存率（OS）高于P-gp表达阴性患者及弱阳性患者。结论:NSCLC患者肺癌组织成纤维细胞P-gp的阳性表达促进了肿瘤细胞逃避免疫和成纤维细胞的耐药性的形成,NSCLC患者癌组织成纤维细胞中P-gp的表达水平对于患者生存时间有重要意义。更多还原

【Abstract】 Objective:To examine the tumor-associated fibroblast（TAF） p-glycoprotein（p-gp） expression in escape immunity and drug resistance and its impacts on the prognosis of lung cancer.Methods:We did a retrospective study on 78 patients with non-small cell lung cancer（NSCLC） who had intact follow-up profiles from the department of thoracic and cardiovascular surgery,Shenzhen Longgang Center Hospital between January 2003and May 2007.The expression of p-gp in TAF derived from lung cancer tissues and normal lung tissues were detected by using Max-Vision^TM immunohistochemical assay.Statistical analysis included chi-square and Fisher’ s exact probability tests,Kruskal-Wallis H analysis for multiple independent groups,Spearman rank correlation analysis for assessment of the correlation,and Kaplan-Meier survival plot for survival analysis.Results:In the 78patients with NSCLC included,p-gp expression in the TAF was associated with sex,tumor differentiation,clinical stage and presence of lymph node metastasis（all P < 0.05）.Patients who tested positively to p-gp yielded a higher progression-free survival and overall survival then those who tested slightly positively or negatively to p-gp following surgical resection.Conclusion:The expression of p-gp in the TAF of NSCLC promotes escape immunity and formation of drug resistance to the tumor and is clinically significant to predict survival outcomes.更多还原