Expression Of P-gp GST-π And Topo Ⅱ In The Malignant Tumor Of Biliary Tract And Its Clinical Significance

Objective: Malignant tumor of biliary tract (cholangiocarcinoma, gallbladder cancer, periampullary cancer) has become one of the common malignant tumors in our country currently, it is harm to the human health seriously. Since its early symptoms are often atypical , surgeons often think and treat it as a benign disease , which often makes the patients miss opportunity of early radical and complete surgery treatment. The treatment of combination therapy becomes a better and final choice. However, because of various reasons, the rate of preoperative diagnosis is low and complete surgical resection of affection tissue is difficult.To a large extent, malignant tumor of biliary tract is mainly depended on the chemical treatment after operation. But in recent years, studies have shown that the phenomenon of multidrug resistance severely is affected by treatment effect during the chemical treatment. The thesis studies the expression of P-gp ,GST-лand TopoⅡof multidrug resistance-associated protein in the malignant tumor of biliary tract and their relationship with the clinical pathology indexes and mutual relationship of them,.the aim is to provide an evidence for the better clinical chemotherapy and prognosis judgement.Methods: This work selected 42 cases of the malignant tumors of biliary tract in the Second Affiliated Hospital of Dalian Medical University, testing the expression levels of P-gp,GST-лand TopoⅡproteins in the tumor organization by immunohistochemistry of peroxidase labeled streptavidin egg sensitized (SP).the positive result is the coloring on the nucleus or cytoplasm, and made the aggregated analysis combining the P-gp, GST-πand TopoⅡwith the clinical pathological factors such as age, gender, depth of invasion, differentiation, lymph node metastasis and and so forth. At the same, this work carried out the further study of three of their mutual relationship between the proteins.Results: The positive expression rate of P-gp, GST-πand TopoⅡin the malignant tumor of biliary tract was 88.1% (37/42), 92.9% (39/42) and 73.8%(31/42), respectively. The expression of P-gp and GST-πwasn't associated with the patients'age, gender, degree of differentiation, the depth of invasion and lymph node metastasis (P>0.05). The expression of TopoⅡwasn't correlated with the patients'age, gender, degree of differe- ntiation, the depth of invasion and lymph node metastasis (P>0.05) but with degree of differentiation (P<0.05). There was a negative correlation between the expression of TopoⅡand degree of differentiation. The expression of P-gp and GST-πhad positive correlation( ( r=0.6613 ,P<0.05).But there wasn't any correlation between expression rate of P-gp and TopoⅡ, GST-πand TopoⅡ(P>0.05).Conclusion: There is a higher expression of P-gp, GST-πand TopoⅡin the malignant tumors of biliary tract, which hints that there is a higher primary drug resistance phenomenon in these patients without chemotherapy. It is a multi-drug resistance-associated protein common participative outcome to biliary tract malignant tumor drug resistance phenomenon. Therefore it is of great significance of detecting aggregated expression of three drug resistance protein for the guiding the choice of clinical chemotherapy drug , instituting reasonable valid treatment project and judging prognosis.