[Predictive value of drug resistance-related genes expression in neoadjuvant chemotherapy in patients with non-small cell lung cancer of stage III].
OBJECTIVE
P-glycoprotein (P-gp), multidrug resistance-associated protein (MRP), and lung resistant protein (LRP) play important roles in multidrug resistance (MDR). This study was to determine P-gp, MRP, and LRP expression in patients with non-small cell lung cancer (NSCLC) of stage III, and evaluate their predictive value in neoadjuvant chemotherapy.


METHODS
Immunohistochemical analyses were performed on 31 patients with NSCLC of stage III before, and after neoadjuvant chemotherapy.


RESULTS
The frequency of P-gp, MRP, and LRP expression were 29.0% (9/31), 45.2% (14/31), and 38.7% (12/31) before chemotherapy, and were 61.3% (19/31), 51.6% (16/31), and 41.9% (13/31) after chemotherapy. Of 31 patients, 10 (10/31, 32.3%) expressed both MRP and LRP before chemotherapy, which indicated significant positive correlation between MRP and LRP expression (r=0.061, P< 0.001). In patients with P-gp, MRP, or LRP expression before chemotherapy, the response rates towards chemotherapy were 44.4% (4/9), 28.6% (4/14), and 16.7% (2/12). Of 10 patients with both MRP and LRP expression, only 1 (1/10, 10.0%) responded to chemotherapy. The median survival time of patients who responded to chemotherapy was 31 months, while that of patients who did not responded to chemotherapy was 15 months, that of patients who didn't receive neoadjuvant chemotherapy before surgery was 18 months.


CONCLUSIONS
Patients with both MRP and LRP expression are probably resistant to chemotherapy, the value of neoadjuvant chemotherapy is limit in such patients.
Department of Thoracic Surgery, Shandong Provincial Hospital, Jinan, Shandong, 250021, PR China. pengzhm@163.com
Zhong-Min
ZM
Peng
Jing
J
Luo
Wei-Bo
WB
Wang
Xiao-Hang
XH
Wang
Jing-Han
JH
Chen
Shou-Min
SM
Lan
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000378:metabolism; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018432:Drug Resistance, Multiple / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000378:metabolism*; D020360:Neoadjuvant Therapy; D009363:Neoplasm Proteins / Q000378:metabolism*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D015996:Survival Rate; D020394:Vault Ribonucleoprotein Particles / Q000378:metabolism*; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077235:Vinorelbine; D000093542:Gemcitabine; D000099187:Major Vault Protein
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D002945:Cisplatin; D003841:Deoxycytidine; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D009363:Neoplasm Proteins; D020394:Vault Ribonucleoprotein Particles; D014747:Vinblastine; D000077235:Vinorelbine; D000093542:Gemcitabine; D000099187:Major Vault Protein