| Background:Lung cancer is the most common incident cancer and the leading cause of cancer death in China and is a major public health problem.Although the treatment of lung cancer has made great advances in surgery,radiotherapy,chemotherapy and molecular targeted therapy in recent years,the treatment effects are still not ideal.For patients with advanced lung cancer,chemotherapy is still the main treatment.multidrug resistance of lung cancer cell is the main cause of chemotherapy failure.CA916798 is a novel gene found by using suppression subtractive hybridization f rom SPCA-1/CDDP,a human adenocarcinoma multi-drug resistance cell line.It is a multidrug resistance gene in lung cancer.It was confirmed at the cellular level and animal level that CA916798 was highly expressed in cancer cells and was low or not express ed in normal lung epithelial cells.What's more,the expression of CA916798 in drug-resistant and normal lung cancer cells was statistically different.However,there is a lack of data on the level of tissue expression in patients with lung cancer before and after chemotherapy,this study will assess the value of CA916798 in predicting drug resistance and prognosis at the clinical level.Objective:To explore the expression and significance of drug resistance gene CA916798 in tissues before and after chemotherapy in patients with clinical lung cancerMethod:1.227 cases of tissue specimens were collected through fiber bronchoscope from lung cancer patients and pathology were analyzed in the southwest hospital from March 2016 to September 2017.2.30 patients who needed chemotherapy after the initial diagnosis and who were willing to undergo further treatment were included in the study,and signed the informed consent;3.The expression of CA916798 mRNA and protein in cancer tissues were analyzed by real-time quantitative PCR(q RT-PCR)and immunohistochemistry in the 30 patients before chemotherapy.4.All of the 30 patients' tumor tissues were collected again through fiber bronchoscope after 2 cycles of chemotherapy;5.The expression of CA916798 m RNA and protein in lung cancer tissues from 30 patients after chemotherapy were analyzed by real-time quantitative PCR(qRT-PCR)and immunohistochemistry;6.Follow-up case data(follow up for at least six months),statistical analysis.Result:1.30 cases of advanced lung cancer patients completed two cycles of chemotherapy and 19 patients were clinically effective(complete remission or partial remission).The overall response rates were 63.33%.2.CA916798 gene mRNA expression level: Among the 19 patients in chemotherapy effective group,the expression of CA916798 in 16 patients were down-regulated,and the proportion was 84.2%.Among the 11 patients in chemotherapy ineffective group,the expression of CA916798 in 8 patients were up-regulated,and the proportion was 72.7%.The two groups were statistically significant(P <0.05).3.CA916798 gene protein expression level: Before chemotherapy,the positive protein expression rates of CA916798 were not statistically significant between chemotherapy ineffective group and chemotherapy effective group.After pre-chemotherapy,The positive rate of CA916798 protein expression in chemotherapy ineffective group(100%,11/11)was higher than that in chemotherapy effective group(42.1%,8/19),which was statistically significant(P <0.05).In the CA916798 protein expression trend,the positive rate of the up-regulation of the CA916798 protein expression in the previous chemotherapy ineffective group was significantly higher than that in the chemotherapy effective group(P <0.05),and which was consistent with the mRNA expression level.4.11 patients who have stable disease after one or two cycles of chemotherapy continue the original or the replacement chemotherapy treatments and 3 patients were clinically effective after re-chemotherapy.We collected the lung cancer tissue through bronchoscopy biopsy and detected the expression of CA916798 m RNA by real-time quantitative PCR(qRT-PCR).We found that,in the re-chemotherapy effective group,the expression of CA916798 mRNA in 3 patientswere down-regulated,and in the re-chemotherapy ineffective group,the expression of CA916798 m RNA in 8 patientswere up-regulated.There were significant difference between the two groups(P <0.05).5.11 patients who have stable disease after two cycles of chemotherapy continue the original or the replacement chemotherapy treatmentsand 3 patients were clinically effective after re-chemotherapy.We collected the lung cancer tissue through bronchoscopy biopsy and detected the expression of CA916798 m RNA by immunohistochemistry.In the re-chemotherapy effective group,the CA916798 protein expression was downtegulated in one case and two cases showed the same trend of expression.In the re-chemotherapy ineffective group,the protein expression of CA916798 gene in 8 patients were also up-regulated.There were significant difference between the two groups(P <0.05).Conclusion:The expression of CA916798 gene in lung cancer patients are significantly correlated with the effect of chemotherapy,which may be a new reference index for predicting the sensitivity of lung cancer chemotherapy. |
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