Feng Y, Hao X, Mao H
Cancer Hospital & Institute, Tianjin Medical University, Tianjin 300060, China.
Zhonghua Yi Xue Za Zhi. 2001 Dec 25;81(24):1484-7.
To discuss the guiding significance of multidrug resistance (MDR) gene expression for monitoring the clinical effectiveness of chemotherapy upon cancer, and to analyze the MDR1 and glutnthione-s-transferase(GST-pi) mRNA expression rates in primary breast cancer, and their correlation with the clinical outcome and prognosis.
The mRNA expression levels of MDR1 in 16 cases with malignant pleural effusion and ascites and 102 cases of solid tumors were measured using semiquantitative RT-PCR assay. The MDR1 and GST-pi mRNA expression rates in 84 cases of breast cancer, out of the 102 cases of solid tumors, were also studied in the same way.
(1) An average coincidence rate of 84.5% was found between the mRNA expression level of MDR1 and the clinical response to chemotherapy in the 16 cases with malignant pleural effusion and ascites and 18 cases of solid tumors. (2) The positive rate of MDR1 mRNA expression in primary breast cancer tissue was 79.7%, with the medium and high levels as high as 33.3%, while the positive rate of GST-pi mRNA expression was 33.3%, with the medium and high expression levels being as low as 4.8%. There was a highly significant difference between the two groups (P < 0.01). The positive rates of MDR1 mRNA in the group having received chemotherapy before surgery and the group not receiving chemotherapy before surgery were 87.8% and 68.6% respectively, showing a lymph nodes and in the group without metastases in axillary lymph nodes were 89.1% and 68.4% respectively, indicating a significant difference (P < 0.05). The positive rates of GST-pi mRNA in the group suffering distant metastases and the group not suffering distant metastases were 71.4% and 20.6% respectively, showing a significant difference (P < 0.05). The GST-pi mRNA expression rates in the estrogen receptor (ER)- and progesterone receptor (PR)-positive groups were higher than those in the ER- and PR-negative groups, indicating a significant difference (P < 0.05) .
The mRNA expression level of MDR1 has a relatively high correlation with the clinical response to chemotherapy, and thus can be used to monitor the effectiveness of chemotherapy. MDR1 is the main drug resistance mechanism in breast cancer. Chemotherapy before surgery induces MDR1 mRNA expression. MDR1 e xpression and GST-pi mRNA expression serve as a significant prognostic indicator for breast cancer, thus having guiding significance for assessing prognosis.
探讨多药耐药（MDR）基因表达对监测癌症化疗临床疗效的指导意义，分析原发性乳腺癌中MDR1和谷胱甘肽 - S - 转移酶（GST - pi）mRNA表达率及其与临床疗效和预后的相关性。
采用半定量逆转录 - 聚合酶链反应（RT - PCR）法检测16例恶性胸腔积液和腹水患者及102例实体瘤患者中MDR1的mRNA表达水平。对102例实体瘤患者中的84例乳腺癌患者，也采用同样方法研究MDR1和GST - pi mRNA表达率。
（1）16例恶性胸腔积液和腹水患者及18例实体瘤患者中，MDR1的mRNA表达水平与化疗临床反应的平均符合率为84.5%。（2）原发性乳腺癌组织中MDR1 mRNA表达阳性率为79.7%，中、高水平高达33.3%；而GST - pi mRNA表达阳性率为33.3%，中、高表达水平低至4.8%。两组间差异有高度显著性（P < 0.01）。术前接受化疗组和未接受化疗组MDR1 mRNA阳性率分别为87.8%和68.6%，差异有显著性（P < 0.05）；腋窝淋巴结有转移组和无转移组MDR1 mRNA阳性率分别为89.1%和68.4%，差异有显著性（P < 0.05）。远处转移组和未发生远处转移组GST - pi mRNA阳性率分别为71.4%和20.6%，差异有显著性（P < 0.05）。雌激素受体（ER）和孕激素受体（PR）阳性组GST - pi mRNA表达率高于ER和PR阴性组，差异有显著性（P < 0.05）。
MDR1的mRNA表达水平与化疗临床反应有较高相关性，可用于监测化疗效果。MDR1是乳腺癌主要的耐药机制。术前化疗可诱导MDR1 mRNA表达。MDR1表达和GST - pi mRNA表达可作为乳腺癌重要的预后指标，对评估预后有指导意义。
