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目的 探讨膀胱癌的多药耐药性(MDR),指导灌注化疗用药。方法 采用免疫组化法检测44例膀胱癌病理标本中P-糖蛋白(P-gp)、谷胱肽S转移酶(GST-π)和拓扑异构酶(TOPO-Ⅱ)的表达,评估肿瘤耐药谱。结果 ①P-gp检测显示,54.5％的病例对阿霉素、丝裂霉素、长春新碱等抗生素类和生物碱类抗癌药高耐药。②GST-π检测显示仅34.1％的病例对顺铂、环磷酰胺等高耐药,而反有56.8％的病例对该类药无耐药或低度耐药。③TOPO-Ⅱ检测显示对阿霉素、柔红霉素、VP16等TOPO-Ⅱ抑制剂类抗癌药,仅13.6％的病例高度耐药,29.5％中度耐药,56.8％低度耐药。结论 检测膀胱癌MDR,了解多药耐药谱,可指导灌注化疗用药。
Objective To investigate the multidrug resistance (MDR) of bladder cancer and guide the infusion chemotherapy. Methods The expressions of P-glycoprotein, GST-π and TOPO-Ⅱ in 44 specimens of bladder cancer were detected by immunohistochemistry Resistance spectrum. Results ①P-gp test showed that 54.5% cases were highly resistant to doxorubicin, mitomycin, vincristine and other antibiotics and alkaloid anticancer drugs. ② GST-π test showed that only 34.1% of the cases of cisplatin, cyclophosphamide and other high resistance, while anti-56.8% of the cases of no or low resistance to these drugs. ③TOPO-Ⅱ test showed that TOPO-Ⅱinhibitor anticancer drugs such as doxorubicin, daunorubicin, VP16 and so on were only highly resistant to 13.6%, moderately resistant to 29.5% and lowly resistant to 56.8%. Conclusion Detection of bladder cancer MDR, understanding of multidrug resistance spectrum, can guide the infusion chemotherapy.