^99mTc-MIBI乳腺癌显像与多药耐药蛋白MRP、Pgp及GST-π关系的研究

Technetium-99m-Sestamibi uptake by breast carcinoma:correlation with p-glycoprotein, multidrug resistance-associated protein and glutathione S transferase-pi

目的探讨乳腺癌确诊患者99mTc-MIBI显像与多药耐药相关蛋白(MRP)、P糖蛋白(Pgp)、胎盘型谷胱甘肽-S-转移酶(GST-π)的关系。方法30例乳腺癌患者,术前行早期及延迟时相99mTc-MIBI乳腺癌显像,术后标本病理及免疫组化检查并测定MRP、Pgp及GST-π水平,分析三者与早期相、延迟相肿瘤/正常组织(T/N)摄取比值和滞留分数(RI)的关系。结果MRP表达阴性组T/N(d)比值和RI明显高于表达阳性组(1.93±0.84Vs1.21±0.51,30%±32%Vs-27%±24%),而MRP表达阴性组与阳性组T/N(e)比值之间无明显差异。Pgp表达阴性组T/N(d)比值明显高于表达阳性组(1.66±0.85Vs1.15±0.30),而Pgp表达阴性组与表达阳性组T/N(e)比值和RI之间无明显差异。GST-π表达阴性组与表达阳性组之间T/N(d)、T/N(e)、RI均无明显差异。结论99mTc-MIBI显像可以检测乳腺癌患者肿瘤细胞内MRP和Pgp的功能,对术后化疗有指导意义。

Objective To evaluate the relationship between the accumulation of ^99mTc-sestamibi and p-glycoproteln （Pgp）, muhidrug resistance-associated protein （MRP） and glutathione S transferase -pi （GST-π） expression in breast carcinoma tissues. Methods Thirty patients underwent early and delayed ^99mTc-sestamibi seintigraphy. Pathological status and immunohistoehemieal studies were performed on multiple nonconsecutive sections of the same tumor using a MRP- specific monoclonal antibody and a Pgp-specifie monoelonal antibody and a GST-π specific monoelonal antibody. Early and delayed tumor-tonormal （T/N） ratios, retention index were correlated with the levels of MRP, Pgp and GST-π expression determined by immunohistochemical studies. Results The T/N （d） ratios were lower for those with MRP and Pgp expression than those with no expression, and there was no statistically significant difference in GST-π. There were no statistically significant differences in T/N （e） ratios between all groups. There was statistically significant difference in RI between those with MRP expression and those with no expression, and no statistically significant difference in the other two groups. Conclusion ^99mTc-MIBI scintimammography is useful in the determination of the presence of MRP and Pgp in patients with breast carcinoma.