【作者】 吴文溪； 沈历宗； 姚冬明； 郑肇巽； 马鸿泰；

【Author】 Wu wen xi, Shen lizong, Yan Dongming,et al. Department of Surgery. The First Afflia ted Hospital of Nanjing Medical University, Nanjing 210029

【机构】 南京医科大学第一附属医院普外科；

【摘要】 目的许多研究证实大肠癌组织有雌激素受体（ER,Estrogen Receptor）高表达,肿瘤多药耐药性（MDR,multidrug resistence）是指肿瘤细胞对多种机构功能及作用机制各不相同的抗肿瘤药物具有交叉耐药,MDRI主要由mdr₁基因编码的一种能量依赖性跨膜糖蛋白—P—糖蛋白 （Pgp,P—glycoprotein）介导的,它能将细胞内药物主动地泵出细胞外,降低细胞内药物蓄积,导致化疗效果降低或失败,大肠癌是PgP高表达肿瘤之一。肿瘤的MDR是可以逆转的,已证实三苯氧氨具有逆转Pgp／mdr1的作用,而三苯氧氨是ER阻断剂,本研究通过检测大肠癌组织ER及Pgp 表达情况,研究两者之间的关系及其临床病理的联系,借以推测ER阻断荆逆转Pgp介导的肿瘤多药耐药性的机制。材料与方法65例大肠癌手术切除标本,其中21例有相应的邻近正常大肠粘膜,均为石膜包埋组织,ER与Pgp的检测均采用免疫组化法,细胞浆、膜或细胞核染呈浅黄至深黄色为阳性,资料行卡方检验。结果 21例正常大肠粘膜ER及Pgp表达率分别为38.1％与 42.9％,相应大肠癌组织ER及PgP表达分别为71.4％与85.7％,显著高于相应正常大肠粘膜（P ＜0.05,P＜0.01）,但是不论大肠癌还是正常大肠癌粘膜ER与Pgp的表达均无相关性（P＞ 0.05）。65例大肠癌组织ER与Pgp的表达率分别为75.38％,73.81％。ER、Pgp表达与病者性别年龄、肿瘤大小形态部位及Dukes分期均无显著性差异。结论大肠癌可能是激素依赖性肿瘤,大肠粘膜在癌变过程中ER和PgP的表达增加,但正常大肠粘膜或大肠癌组织ER、Pgp表达均无明显相关性;ER、Pgp作为单一指标并不能作为判断大肠癌病情及预后的依据;ER阻断剂逆转Pgp 介导的MDR可能与其阻断ER的作用无关。更多还原

【Abstract】 To examine the expression of ER and Pgp in primary colorectal carcino mas, their relationship and the relationships between ER/Pgp and tumor behavior, and to inves tigate the mechnism of ER blocker—Tamoxifen to reverse MDR mediated by Pgp. Materials and Methodes Sixty five paraffin embeded samples of primary colorectal carcinomas, with 20 of these accompanied by nearby normal mucosae, were reviewed. ER and Pgp were determined by using immunohistochemistry. Differences were evaluated by Chi-square tests. Results The expressive rates of ER and Pgp in primary colorectal carcinomas were higher than those of normal colorectal mucosac (P＜0.05, P＜0.01, rcspcctivcly). ER and Pgp were detected in 75.38％ and 73.84％ of the carcinomas respectively. ER expression was undependent of sex and age of the patients, size site and Dukes stage f the tumors, So did Pgp expression. Conclusion Primary colorectal carcino ma may be one of hormone—dependent tumors. ER expression in ormal mucosae or in primary colorectal carcinoma is not associated ith that of Pgp. S the reversal of Pgp—mediatd MDR by Tamoxifen may ave nothing to do with its function of blocking ER. The expressive ares of ER and Pgp increase in the course of carcinogenesis of olorectal mucosa. ER or Pgp can’t be indica tion for diterming the stage and prognosis of primary colorectal carcinoma.更多还原