P-糖蛋白(Pgp)在乳腺癌中的表达及与预后的关系

The relationship between expression of P-glycoprotein and prognosis in breast cancer

目的探讨P-糖蛋白(P-glycoprotein,Pgp)在乳腺癌中的表达,评估其在乳腺癌预后中的作用。方法对我院1993年1月～1994年12月用免疫组织化学方法检测62例手术切除的乳腺癌组织中Pgp的表达的资料进行回顾分析,研究其与临床病理特征的关系及对预后的影响。结果(1)Pgp在乳腺癌组织中的阳性表达率为32.2%(20/62)。(2)Pgp表达与月经状况、肿瘤大小、腋淋巴结转移个数、组织学分级之间均无相关性(P>0.05)。(3)Kaplan-Meier生存分析结果表明Pgp阴性表达组的无病生存期(DFS)及总生存期(OS)均明显优于阳性表达组(P<0.05)。(4)Cox回归单因素分析显示腋窝淋巴结转移个数、组织学分级、肿瘤大小、TNM分期及Pgp表达与DFS及OS明显相关;Cox回归多因素分析表明除了腋窝淋巴结转移个数、组织学分级及肿瘤大小与DFS及OS明显相关外,Pgp表达与OS缩短有关,但和DFS无关。结论Pgp在乳腺癌组织中有一定程度的表达,Pgp阳性表达与乳腺癌患者生存期的缩短有关,有可能成为判断乳腺癌患者预后的指标。

Objective To investigate the expression of P-glycoprotein （Pgp） in breast cancer and evaluate it＇s effect on prognosis of breast cancer. Methods An immunohistochemical method was used to detect expression level of Pgp in 62 cases with breast cancer. And it＇s relationship between clinical pathological features and prognosis were studied. Results ① The expression rate of Pgp in breast cancer tissues was 32.3% （20 in 62）. ②There was no correlation between Pgp expression and menopausal status, tumor size, axillary metastatic lymph node numbers and histological grades（P〉0.05）. ③ The results of kaplan-Meier survival showed that the disease free survival peroid and overall survival period of Pgp negative expression group were much superior to the Pgp positive expression group （P〈0.05）. ④Cox single factor regression analysis showed that DFS and OS were markedly correlated with axillary metastatic lymph node numbers,histological grades, tumor size, TNM stages and Pgp expression. However,Cos multi-factors regression analysis showed that the Pgp expression correlated with shortening of QS and it was not correlated with DFS. Conclusions Pgp showed some degree of expression in breast cancer tissue. The positive Pgp expression is correlated with the shortening survival period of berast cancer. Pgp is seemed to be an index to evaluate prognosis in breast cancer patients.