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研究非小细胞肺癌 (NSCLC)患者多药耐药基因 (MDR1)表达与化疗疗效间的关系 ,观察环孢霉素 (CsA)逆转MDR1的疗效及毒性。方法 利用RT PCR技术检测 46例NSCLC患者肿瘤细胞和外周血淋巴细胞MDR1表达 ,根据检测结果将患者分成MDR1阳性逆转组、MDR1阳性对照组和MDR1阴性组。所有患者接受至少 2个周期的化疗 ,阳性逆转组患者在化疗同时给予CsA ,剂量为 4mg/kg。结果 肿瘤细胞MDR1阳性率为 6 5 .2 % (30 /4 6 ) ,外周血淋巴细胞MDR1阳性率为 5 8.7% (2 7/4 6 ) ,2 4例患者为肿瘤细胞和外周血淋巴细胞MDR1均阳性。复发患者阳性率为 81.3% (2 6 /32 ) ,多程化疗患者阳性率为 85 .7% (2 4/2 8) ,明显高于初治或未行化疗患者。阳性逆转组化疗有效率为 46 .7% (7/15 ) ,对照组为 2 0 % (3/15 ) ,阴性组为 37.5 % (6 /16 ) ,阳性逆转组的血液毒性和肝功能损害较其他组增高 ,其余毒副反应及免疫功能改变无明显差异。结论 RT PCR法检测MDR1表达对评估NSCLC多药耐药、化疗疗效及预后具有一定临床价值。CsA对MDR1表达的逆转作用尚需扩大样本进行研究
To investigate the relationship between the expression of multidrug resistance gene (MDR1) in patients with non-small cell lung cancer (NSCLC) and the efficacy of chemotherapy, and to observe the efficacy and toxicity of cyclosporine (CsA) in reversing MDR1. Methods RT-PCR was used to detect the expression of MDR1 in tumor cells and peripheral blood lymphocytes of 46 NSCLC patients. According to the test results, patients were divided into MDR1 positive reversal group, MDR1 positive control group and MDR1 negative group. All patients received at least 2 cycles of chemotherapy, and the positive reversal group received CsA concurrently with chemotherapy at a dose of 4 mg/kg. Results The positive rate of MDR1 in tumor cells was 65.2% (30/46), the positive rate of MDR1 in peripheral blood lymphocytes was 58.7 % (2 7/46), and 24 cases were tumor cells and peripheral blood lymphocytes. MDR1 is positive. The positive rate of relapsed patients was 81.3% (26/32), and the positive rate of multi-pass chemotherapy patients was 85.7% (2 4/2 8), which was significantly higher than that of patients who were initially treated or not. The effective rate of chemotherapy in the positive reversal group was 46.7% (7/15), 20% (3/15) in the control group, and 37.5 % (6/16) in the negative group. Hematologic toxicity and liver function impairment in the positive reversal group Compared with other groups, there was no significant difference in other toxic side effects and immune function changes. Conclusion The detection of MDR1 expression by RT PCR has certain clinical value in evaluating multidrug resistance, chemotherapy efficacy and prognosis of NSCLC. The reversal effect of CsA on MDR1 expression needs to be expanded to study