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目的:探讨代表不同耐药机制的P糖蛋白(P-gp)、谷胱甘肽S-转移酶(GST-π)、DNA拓扑异构酶Ⅱ(TopoⅡ)、胸苷酸合成酶(TS)在原发宫颈鳞癌组织中的表达及其与临床病理参数的关系;分析三磷酸腺苷生物荧光法体外药敏试验(ATP-TCA)结果与耐药蛋白表达的关系。方法:收集32例宫颈鳞癌患者的新鲜癌组织制成单细胞悬液,采用ATP-TCA法成功检测上述细胞对11种化疗药物(共16种组合)的体外敏感性;采用EnVision二步法免疫组化检测32例宫颈鳞癌组织中P-gp、GST-π、TopoⅡ、TS蛋白的表达,并分析其与临床分期、肿瘤分化程度的关系。结果:耐药蛋白P-gp、GST-π、TopoⅡ、TS在宫颈鳞癌组织中的表达与临床分期、肿瘤分化程度无相关性;耐药蛋白P-gp表达与体外PTX+CBP耐药正相关(P=0.040);耐药蛋白TS表达与体外5-FU、5-FU+MMC、5-FU+DDP耐药正相关(P=0.015,0.012,0.006);TopoⅡ,GST-π蛋白表达与宫颈鳞癌体外耐药均无相关性。结论:体外药敏试验联合免疫组化检测,有可能用于宫颈鳞癌化疗前药敏预测。
Objective: To investigate the expression of P-gp, GST-π, TopoⅡ and thymidylate synthase (TS) In primary cervical squamous cell carcinoma and its relationship with clinicopathological parameters. The relationship between ATP-TCA and drug-resistant protein expression was analyzed by biofluorescence assay. Methods: 32 cases of fresh squamous cell carcinoma of the cervical squamous cell carcinoma were collected to make single cell suspension. The sensitivity of these cells to 11 chemotherapeutic agents (16 combinations) was tested by ATP-TCA method in vitro. EnVision two- The expression of P-gp, GST-π, TopoⅡ and TS in 32 cases of cervical squamous cell carcinoma were detected by immunohistochemistry. The relationship between them and the clinical stage and tumor differentiation was analyzed. Results: The expressions of P-gp, GST-π, TopoⅡ and TS in cervical squamous cell carcinoma were not correlated with clinical stage and tumor differentiation. The expression of P-gp and PTX + CBP (P = 0.040). The expression of TS protein was positively correlated with the drug resistance of 5-FU, 5-FU + MMC and 5-FU + DDP in vitro (P = 0.015,0.012,0.006) No correlation with cervical squamous cell carcinoma in vitro resistance. Conclusion: In vitro susceptibility testing combined with immunohistochemical detection may be used for the prediction of susceptibility to cervical squamous cell carcinoma before chemotherapy.