Evaluation of Neoadjuvant Chemotherapy and Expression of Multidrug Resistance Indicater in Gastrointestinal Carcinomas_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China;

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Keywords：

Gastric carcinoma; Colorectal carcinoma; Multidrug resistance; Neoadjuvant chemotherapy

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ObjectiveTo evaluate the effect of neoadjuvant chemotherapy and find the mechanism of multidrug resistance. MethodsTwenty patients with gastric cancer and 31 patients with colorectal cancer underwent neoadjuvant chemotherapy and then operations. The preoperative specimens were stained by immunohistochemical techniques for testing p53,multidrug resistanceassociated protein (MRP), glutathione S transferase（GST）, telomerase. Resection specimens were evaluated for chemotherapy effect by routine histology; at the same time, the postoperative morbidity and mortality were observed. ResultsIn 51 patients, the response rate of neoadjuvant chemotherapy was 27.45%(14/51),so multidrug resistance was a kind of common phenomena in gastrointestinal carcinomas. The postoperative morbidity was 15.69%(8/15), the main operation complication was infection,the mortality was 1.96%(1/51),only one person died from severe infection.The expression rate of p53, MRP, GST, telomerase was 58.0%,51.0%,66.7%,74.0%respectively, the location of p53 was at cell nucleus,location of MRP,GST was at cell memberane and cytoplasm,location of telomerase was at cytoplasm.The response rate had nothing to do with age, sex and metastasis. But it was related with p53 and telomerase expression. ConclusionNeoadjuvant chemotherapy is an effective, safe therapy. But the rate of drug resistance is high in gastrointestinal carcinomas, and the response rate is related to p53, telomerase expression.

Citation： ZHANG Yan,ZHOU Jisheng,LI Fei,LIU Yanpeng,CUI Yeqing,ZHAO Lan,SUN Jiabang. Evaluation of Neoadjuvant Chemotherapy and Expression of Multidrug Resistance Indicater in Gastrointestinal Carcinomas. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2003, 10(2): 140-143. doi: Copy

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1. Fink U,Stein HJ,Schuhmacher C, et al. Neoadjuvant chemotherapy for gastric cancer: update [J]. World J Surg, 1995； 19(4)∶509.
2. 韩企夏.乳腺癌新辅助化疗进展 [J]. 中国普外基础与临床杂志, 1998； 5（5）∶296.
3. Becker K, Fumagalli U, Mueller JD, et al. Neoadjuvant chemotherapy for patients with locally advanced gastric carcinoma: effect on tumor cell microinvolvement of regional lymph nodes [J]. Cancer, 1999; 85(7)∶1484.
4. 顾晋，马朝来，叶颍红,等.结肠、直肠癌术前区域动脉灌注化疗的临床病理观察 [J]. 中华外科杂志， 1999； 37(6)∶333.
5. Lowy AM, Mansfield PF, Leach SD, et al. Response to neoadjuvant chemotherapy best predicts survival after curative resection of gastric cancer [J]. Ann Surg, 1999； 229(3)∶303.
6. Zaman GJ, Flens MJ, van Leusden MR, et al. The human multidrug resistanceassociated protein (MRP) is a plasma membrane drugefflux pump [J]. Proc Natl Acad Sci USA, 1994; 91(19)∶8822.
7. 魏虎来. 白血病细胞多药耐药及其干预对策 [J]. 国外医学输血及血液学分册，2000； 23（1）∶28.
8. Ishikawa T, Kamiyama M, Hisatomi H, et al. Telomerase enzyme activity and RNA expression in adriamycinresistance human breast carcinoma MCF7 cells [J]. Cancer Lett, 1999； 141(1-2)∶187.
9. Schipper DL, Wagenmans MJ, Peters WH, et al. Glutathione Stransferases and indodeoxyuridine labelling index during chemotherapy of gastric cancer [J]. Anticancer Res, 2000; 20(3A)∶1705.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Evaluation of Neoadjuvant Chemotherapy and Expression of Multidrug Resistance Indicater in Gastrointestinal Carcinomas

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