多药耐药类蛋白对乳癌新辅助化疗疗效的影响

Effect of multidrug-resistant-proteins in neoadjuvant chemotherapy in patients with breast cancer

目的:评价乳癌组织多药耐药类蛋白P-糖蛋白(P-gp)、谷胱甘肽转移酶(GST-π)、拓扑异构酶Ⅱ(TopoⅡ)表达对新辅助化疗近期疗效的预测价值。方法:采用免疫组织化学方法检测100例乳癌患者新辅助化疗前后肿瘤组织中P-gp、GST-π及TopoⅡ的表达,并与疗效作相关性分析。结果:P-gp在化疗前后的阳性表达率分别为42%和65%,差异有统计学意义(P<0.05);GST-π在化疗前后阳性表达率分别为65%和70%,差异无统计学意义(P>0.05);TopoⅡ化疗前后阳性表达率分别为40%和35%,差异无统计学意义(P>0.05)。P-gp与GST-π化疗前共表达率为40%,呈正相关(r=0.539,P<0.01)。P-gp、GST-π及TopoⅡ阳性者化疗有效率分别为28.6%、46.2%、75.0%,阴性者分别为55.0%(P<0.05)、60.0%(P>0.05)、35.0%(P<0.05)。P-gp与GST-π同时阳性者化疗有效率为25%。结论:P-gp和TopoⅡ对乳癌新辅助化疗疗效有一定预测价值。

Aim： To determine the expressions of P-glycoprotein（P-gp） ,glutathione S-transferase Pi（GST-π,and topoisomerase Ⅱ （Topo Ⅱ ） in patients with breast cancer, and evaluate their predictive value in neoadjuvant chemotherapy. Methods： The expressions of P-gP,GST-πand Topo Ⅱ were determined in 100 patients with breast cancer before and after neoadjuvant chemotherapy. Results：The positive expression rate of P-gp was 42% and 65% before and after chemotherapy, respectively, and the difference was statistically significant （ P 〈 0.05 ）. The positive expression rate of GST-π was 65 % and 70% ,and those of Topo Ⅱ was 40% and 35% before and after chemotherapy, respectively,and there was no significant differences in both GST-π and Topo Ⅱ positive expression rate before and after chemotherapy（ P 〉 0.05 ）. P-gp and GST-π positive expressions were positively correlated before chemotherapy （ r = 0. 539, P 〈 0.01 ）. In patients with P-gp, GST-π, and Topo Ⅱ positive expression,the response rates towards chemotherapy were 28.6% ,46.2% ,and 75.0% ,and in patients without P-gp, GST-π, and Topo Ⅱ positive expression, the response rates were 55.0% （ P 〈 0.05 ） ,60.0% （ P 〉 0.05 ） , and 35.0% （P 〈0.05 ）, respectively. The response rate of patients with both P-gp and GST-π expression was 25%. Conclusion ： P-gp and Topo Ⅱ can be used to predict the therapeutic effect of neoadjuvant chemotherapy.