乳腺癌^99mTc—MIBI显像与MRP，Ki-67表达的关系

The relationship between ^99mTc-MIBI breast cancer imaging and the expression of multidrug resistance-associated protein and Ki-67

目的:探讨99mTc-MIBI乳腺显像与人类乳腺癌组织中耐药蛋白MRP、Ki-67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)与延迟(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MRP、Ki-67表达。比较MRP阳性组与阴性组、Ki-67阳性组与阴性组患者间肿瘤部位放射性清除指数的差异。结果:MRP阳性组清除指数(16.72±10.17)明显高于阴性组(1.76±2.38),两者差异有显著性(t=3.020,P<0.005);Ki-67阳性组清除指数(12.47±11.26)与阴性组清除指数(13.06±12.63)间差异无显著性(t=0.249,P>0.50)。结论:99mTc-MIBI乳腺显像清除指数与乳腺癌MRP表达水平呈正相关(r=0.738,P<0.001),99mTc-MIBI乳腺显像清除指数分析可用于乳腺癌MRP表达水平的评估,而99mTc-MIBI乳腺显像清除指数与Ki-67表达之间没有发现有意义的相互关系。

Objective： To investigate the relationship between ^99mTc-MIBI breast imaging results and expression of the drug resistance proteins[multidrug resistance-associated protein（MRP）, Ki-67] in human breast cancer tissues. Methods： Thirty-six patients with untreated breast cancer were studied prospectively a week before their surgical operations. They were all injected intravenously with 740MBq ^99mTc-MIBI in the arm contralateral to the lesion. Anterior planar images were acquired at 10 and 180 minutes after injection and radioactive washout indices（WI） were calculated. MRP, Ki-67 expression was investigated by immunobistocbemical studies on multiple nonconsecutive sections of surgical samples. The differences of the tumor radioactive WI between MRP positive and negative groups, Ki-67 positive and negative groups were compared with. Results： The Wl were significantly higher in 13 patients with positive MRP expression when compared with 23 patients with negative MRP expression（16.72±10.17 and 1.76±2.38, P〈0.005）. However, the differences of WI between the patients with positive and negative Ki-67 expressions were not signifieant（12.47±11.26 and 13.06±12.63, P〉0.50）. Conclusions： A strong positive correlation was found between the WI of ^99mTc-MIBI from the lesions and expression of MRP in untreated breast cancer patients（r=0.783, P〈 0.001）. The WI of ^99mTc-MIBI breast imaging may be a useful method for evaluating MRP expression in breast cancer. No significant relationship between ^99mTc-MIBI breast imaging results and Ki-67 was found.