小儿恶性肿瘤化疗前后外周血多药耐药基因,多药耐药相关蛋白基因,肺耐药蛋白基因的变化及临床意义.docVIP

小儿恶性肿瘤化疗前后外周血多药耐药基因、多药耐药相关蛋白基因、肺耐药蛋白基因的变化及临床意义 邓晓斌，王 珊，邹 琳，李长春，章 均，欧阳军 (400014 重庆，重庆医科大学附属儿童医院肿瘤外科) [摘要] 目的 探讨实体恶性肿瘤化疗患儿外周血单个核细胞（peripheral blood mononuclear cells，PBMCs）中多药耐药基因（multi-drug resistance1，MDR1）、多药耐药相关蛋白基因（multi-drug resistance-associated protein1，MRP1）、肺耐药蛋白基因（lung resistance protein，LRP）的表达量及其与临床化疗的关系。方法 应用实时荧光定量PCR(real-time fluorescence quantitative PCR，FQ-PCR)技术，检测患儿化疗前后外周血和手术切除新鲜冻存组织，以及对照组外周血中MDR1、MRP1、LRP的mRNA表达量。结果 所有化疗患儿外周血MDR1表达量与同期手术切除的肿瘤组织MDR1表达量存在正相关(r = 0.894, P = 0.000)；化疗前后外周血MDR1表达量变化与肿瘤大小变化间存在负相关,神经母细胞瘤（r = -0.733, P = 0.000），卵黄囊瘤（r = -0.874, P = 0.000），淋巴瘤（r = -0.617, P = 0.005）；化疗前外周血MDR1表达量与首次化疗后相应肿瘤标志物变化大小呈负相关，神经母细胞瘤尿香草杏仁酸（VMA）（r = -0.440, P = 0.046），卵黄囊瘤甲胎蛋白（AFP）（r = -0.831, P = 0.000），淋巴瘤乳酸脱氢酶（LDH）（r = -0.495, P = 0.031）。随着化疗次数的增加MDR1表达量增加（P0.05）。结论 动态检测患儿化疗前后PBMCs中MDR1 mRNA水平对化疗疗效及预后的判定有一定的指导意义,可在一定程度上指导化疗方案的修订。 [关键词] 小儿实体恶性肿瘤；多药耐药基因；多药耐药相关蛋白基因；肺耐药蛋白基因； 外周血；荧光定量PCR [中图法分类号] [文献标志码] A [基金项目] 重庆医科大学校级重点课题（XBZD200708） [通信作者] 王 珊，电话：（023E-mail：wangshan778@163.com Expressions and significance of MDR1, MRP1 and LRP in peripheral blood of chemotherapy children with malignant solid tumors Deng Xiaobin, Wang Shan, Zou Lin, Li Changchun, Zhang Jun, Ouyang Jun (Department of Surgical Oncology, Children’s Hospital, Chongqing Medical University, Chongqing, 400014, China) [Abstract] Objective To investigate the expressions of multi-drug resistance gene (MDR1), multi-drug resistance-associated protein gene (MRP1), and lung resistance protein gene (LRP) in the peripheral blood mononuclear cells in chemotherapy children with malignant solid tumors and its relationship with clinical chemotherapy. Methods A total of 59 children with malignant solid tumors at an age from 9 months to 14 years old who admitted in our hospital from January 2008 to October 2009 were collected in this study. There were 24 cases of neuroblastoma, 16 cases of yolk sac tumor, and 19 cases of lymphoma. An