目的:探讨P-糖蛋白(P-glycoprotein,P-gp)、DNA拓扑异构酶Ⅱα(topoisomeraseⅡα,ToPoⅡα)、谷胱甘肽-S-转移酶(glutathione-S-transferaseπ,GST-π)和原癌基因c-erbB2在子宫内膜癌中的表达情况及其临床意义。方法:运用免疫组织化学SP法检测P-gp、ToPoⅡα、GST-π和c-erbB2在127例子宫内膜癌中的表达情况。结果:127例子宫内膜癌中,P-gp表达率为63.0%,ToPoⅡα为44.9%,GST-π为70.1%,c-erbB2为47.2%;P-gp和GST-π共同表达率为50.7%。P-gp、GST-π和c-erbB2的表达率,低分化高于中、高分化子宫内膜癌(P<0.05);ToPoⅡα表达率,中、高分化高于低分化子宫内膜癌(P<0.05)。单因素分析表明,P-gp、GST-π和c-erbB2的表达与子宫内膜癌患者的生存期和不良预后有关。COX回归分析表明,P-gp表达、P-gp和GST-π共同表达与患者的生存率有关,ToPoⅡα高表达对患者有保护趋势。结论:P-gp、ToPoⅡα、GST-π和c-erbB2等多因素联合作用是子宫内膜癌多药耐药性的主要作用机制。测定子宫内膜癌患者进行此4项指标,对于患者预后的估计和制定合理的化疗方案具有积极的指导意义。 Objective: To investigate the expression of P-glycoprotein (P-gp), topoisomeraseⅡα (ToPoⅡα), glutathione-S-transferase (GST-π) Expression of proto - oncogene c - erbB2 in endometrial carcinoma and its clinical significance. Methods: The expressions of P-gp, ToPoⅡα, GST-π and c-erbB2 in 127 cases of endometrial carcinoma were detected by immunohistochemical SP method. Results: The expression of P-gp in 63 cases of endometrial carcinoma was 63.0%, ToPoⅡα was 44.9%, GST-π was 70.1%, c-erbB2 was 47.2%. The co-expression of P-gp and GST-π was 50.7 %. The expression rates of P-gp, GST-π and c-erbB2 were higher in poorly differentiated and moderately differentiated endometrial carcinomas (P <0.05). The expression rates of ToPoⅡα were higher than those in poorly differentiated endometrial carcinomas P <0.05). Univariate analysis showed that the expression of P-gp, GST-π and c-erbB2 correlated with the survival and poor prognosis of patients with endometrial cancer. COX regression analysis showed that the co-expression of P-gp, P-gp and GST-π was related to the survival rate of patients, and the high expression of ToPoⅡα had a protective trend in patients. Conclusion: The multi-factor combination of P-gp, ToPoⅡα, GST-π and c-erbB2 is the main mechanism of multidrug resistance in endometrial carcinoma. Determination of endometrial cancer in patients with these four indicators, the prognosis of patients and to develop a reasonable program of chemotherapy has a positive guiding significance.