Clinical significance of multidrug resistance and P-glycoprotein expression in patients with gastric carcinoma.
Twenty-four fresh tumors of gastric carcinoma were assessed by flow cytometric detection of P-glycoprotein (P-gp) using monoclonal antibody C219. Eight patients were P-gp positive. Differentiated gastric carcinomas contained significantly higher concentrations of P-gp positive. Incidence of P-gp positive was high in advanced stage. In 16 cases estimated chemosensitivity was test assessed by thymidine incorporation assay (TIA). Seven of nine multidrug-resistant cases according to TIA were P-gp positive and all of seven nonmultidrug resistant cases were P-gp negative. Expression of P-gp and multidrug resistance were closely correlated (P < 0.01). Also, in 89 patients with operable gastric carcinoma, the relation between in vitro chemosensitivity test (TIA) and their clinicopathologic features as well as their survival lengths were studied. Thirty-one of 89 specimens from gastric carcinoma patients were multidrug resistant according to TIA. Patients in the multidrug-resistant group had a significantly poorer cumulative survival rate than those who were not multidrug resistant (P < .05). The multivariate analysis showed that multidrug resistance is a useful indicator of prognosis (P < 0.1). We suggest that multidrug-resistant cases or P-gp-positive cases of gastric carcinoma are highly malignant, and these determinations are clinically useful.
Fujii
H
H
Second Department of Surgery, Fukui Medical School, Japan.
Tanigawa
N
N
Muraoka
R
R
Shimomatsuya
T
T
Tanaka
T
T
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal; D002277:Carcinoma / Q000378:metabolism / Q000503:physiopathology* / Q000556:secondary; D018432:Drug Resistance, Multiple; D004354:Drug Screening Assays, Antitumor / Q000379:methods; D005260:Female; D005434:Flow Cytometry; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D016019:Survival Analysis; D013936:Thymidine
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D000911:Antibodies, Monoclonal; D013936:Thymidine