耐药蛋白表达与^(99m)Tc-MIBI乳腺显像的关系

Expression of drug resistance protein related to ^(99m)Tc-MIBI breast imaging

目的探讨99mTc-MIBI乳腺显像与人类乳腺癌组织中耐药蛋白P-gp、突变型P53表达之间的关系。方法对36例未经治疗的乳腺癌患者实施99mTc-MIBI早期(10min)与晚期(180min)平面显像,并根据99mTc-MIBI乳腺显像计算肿瘤部位99mTc-MIBI放射性清除指数(WI),应用免疫组织化学方法检测术后标本中耐药蛋白P-gp、突变型P53表达。比较P-gp阳性组与阴性组、突变型P53阳性组与阴性组患者间肿瘤部位放射性清除指数(WI)的差异。结果P-gp阳性组清除指数(17.16±11.67)明显高于阴性组(1.95±3.52),两者差异有显著性(t=3.022,p<0.001);突变型P53阳性组清除指数(13.55±11.10)与阴性组清除指数(12.53±16.44)间差异无显著性(t=0.196,p>0.50)。结论99mTc-MIBI乳腺显像清除指数分析可用于乳腺癌P-gp表达水平的评估,而99mTc-MIBI乳腺显像清除指数与突变型P53表达之间没有发现有意义的相互关系。

Objective The purpose of this study was to evaluate the relationship between 99mTc-MIBI breast imaging results and expression of the drug resistance proteins(P-glycoprotein(P-gp),mutant p53) in human breast cancer tissues. Methods 36 patients with untreated breast cancer were studied prospectively a week before their surgical operations. They were all injected intravenously with 740 MBq (20mCi) 99mTc-MIBI in the arm contralateral to the lesion. Anterior planar images were acquired at 10 and 180 minutes after injection and radioactive washout indice (WI) were calculated. P-gp,mutant p53 expression was investigated by Immunohistochemical studies on multiple nonconsecutice sections of surgery samples. The differences of the tumour radioactive washout indice between P-gp positive and negative groups, mutant p53 positive and negative groups were compared with. Results the WI were significantly higher in 27 patients with positive P-gp expression when compared with 9 patients with negative P-gp expression(17.16 ± 11.67 and 1.95 ± 3.52 , p<0.001).However , the differences of WI between the patients positive and negative mutant p53 _expression were not significant (13.55 ± 11.10 and 12.53 ± 16.44 , p>0.50). Conclusions The WI of 99mTc-MIBI breast imaging may be a useful method for evaluating P-gp expression in breast cancer. No significant relationship between 99mTc-MIBI breast imaging results and mutant p53 was found .