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目的:探讨非小细胞肺癌(non-small cell lung cancer,NSCLC)中耐药相关蛋白--肺耐药蛋白(lung resistance protein,LRP)、谷胱甘肽-S-转移酶π(glutathione-S-transferaseπ,GST-π)、核苷酸切除修复交叉互补基因1(excision repair cross-comple-tion group1,ERCC1)蛋白和凋亡抑制基因Survivin蛋白表达的临床意义。方法:用Envision免疫组化方法检测南京医科大学第一附属医院呼吸科64例病理确诊为NSCLC患者组织中LRP、GST-π、ERCC1蛋白和Survivin蛋白的表达情况,并将其与患者的病理类型、细胞分化程度、有无淋巴结转移、临床分期及铂类化疗效果等临床特征进行比较分析。结果:LRP、GST-π、ERCC1蛋白和Survivin蛋白的阳性表达率分别为60.9%、56.3%、60.9%和54.7%;NSCLC低分化组中LRP阳性表达率较高(85.0%),GST-π表达比例随分化程度降低而降低,ERCC1蛋白在鳞癌中表达显著增高(80.0%),Survivin蛋白在腺癌中表达显著增高(81.5%),均存在统计学差异(P<0.05);LRP与GST-π的表达呈正相关(R=0.262,P=0.036);回归分析表明LRP、ERCC1蛋白表达与化疗效果有关;且ERCC1蛋白阴性患者中,LRP阳性表达患者的化疗有效率显著降低(P<0.05)。结论:不同类型的NSLCL中,4种耐药相关蛋白的表达水平不同;LRP、GST-π存在协同表达;联合检测ERCC1蛋白、LRP能更好的预测NSCLC对铂类化疗的效果。
OBJECTIVE: To investigate the relationship between drug resistance-related proteins lung resistance protein (LRP) and glutathione-S (P-selectin) in non-small cell lung cancer -transferaseπ, GST-π), and the expression of Survivin protein in excision repair cross-complementation group 1 (ERCC1). Methods: The expression of LRP, GST-π, ERCC1 protein and Survivin protein in 64 NSCLC patients diagnosed by Department of Respiratory Medicine, First Affiliated Hospital of Nanjing Medical University were detected by Envision immunohistochemical method and compared with the pathological type , The degree of cell differentiation, with or without lymph node metastasis, clinical stage and platinum-based chemotherapy and other clinical features were compared. Results: The positive rates of LRP, GST-π, ERCC1 and Survivin were 60.9%, 56.3%, 60.9% and 54.7%, respectively. The positive rate of LRP in NSCLC poorly differentiated group was 85.0% The expression of ERCC1 was significantly increased in squamous cell carcinoma (80.0%) and Survivin protein was significantly increased in adenocarcinoma (81.5%), both of which were significantly different (P <0.05). The expressions of LRP and The expression of LRP and ERCC1 protein was positively correlated with the chemotherapeutic effect in patients with ERCC1 protein negative expression (P <0.05), and the expression of GST-π was positively correlated (R = 0.262, P = 0.036) 0.05). CONCLUSION: The expression levels of four drug-resistance-related proteins are different in different types of NSLCLs. Synergistic expression of LRP and GST-π exists. Combined detection of ERCC1 protein and LRP can better predict the effect of NSCLC on platinum-based chemotherapy.