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目的研究不同新辅助化疗方案对宫颈癌耐药基因表达的影响。方法选择新辅助化疗TP或TC方案对112例宫颈癌患者行术前化疗,用免疫组织化学法分别检测化疗前后同一宫颈癌患者耐药基因P-糖蛋白(P-gp)、谷胱甘肽S-转移酶-π(GST-π)和DNA拓扑异构酶-Ⅱ(Topo-Ⅱ)的表达情况。结果耐药基因P-gp、GST-π及Topo-Ⅱ的表达不受宫颈癌临床病理特征的影响,P-gp和GST-π化疗后的阳性表达水平高于化疗前,差异无统计学意义(P>0.05);Topo-Ⅱ化疗后的阳性表达水平低于化疗前,差异有统计学意义(P<0.01)。新辅助化疗前后P-gp、GST-π和Topo-Ⅱ的变化相互间存在统计学上的相关性(P<0.01)。TP或TC方案治疗对P-gp、GST-π和Topo-Ⅱ的表达影响比较,差异无统计学意义(P>0.05)。结论 TP或TC方案的新辅助化疗不增加P-gp和GST-π的表达,但可降低Topo-Ⅱ的表达,TP或TC方案的新辅助化疗对耐药基因的表达影响无差异,建议宫颈癌新辅助化疗可考虑首选TP或TC方案。
Objective To investigate the effects of different neoadjuvant chemotherapy regimens on the expression of drug resistance genes in cervical cancer. Methods One hundred and twelve cervical cancer patients underwent chemotherapy with neoadjuvant chemotherapy (TP or TC). Immunohistochemistry was used to detect the expression of P-glycoprotein (P-gp), glutathione S-transferase-π (GST-π) and DNA topoisomerase-Ⅱ (Topo-Ⅱ) expression. Results The expressions of P-gp, GST-π and Topo-Ⅱ were not affected by the clinicopathological features of cervical cancer. The positive expression levels of P-gp and GST-π after chemotherapy were higher than those before chemotherapy, with no significant difference (P> 0.05). The positive expression of Topo-Ⅱ after chemotherapy was lower than that before chemotherapy (P <0.01). The changes of P-gp, GST-π and Topo-Ⅱ before and after neoadjuvant chemotherapy were statistically significant (P <0.01). The effects of TP or TC regimen on the expression of P-gp, GST-π and Topo-Ⅱ were not statistically different (P> 0.05). Conclusions Neoadjuvant chemotherapy with TP or TC regimen does not increase the expression of P-gp and GST-π, but decreases the expression of Topo-Ⅱ. There is no difference in the expression of drug-resistant genes between TP or TC neoadjuvant chemotherapy, suggesting that cervical Neoadjuvant chemotherapy may consider the preferred TP or TC regimen.