乳腺癌组织中多药耐药基因的表达及其临床意义

Expression and clinical significance of some multidrug resistant gene in breast carcinoma tissue

目的探讨多药耐药基因蛋白P-糖蛋白(P-gp)、谷胱甘肽-S-转移酶-π(GST-π)及DNA拓扑异构酶Ⅱ(TopoⅡ)在乳腺癌组织中的表达及其临床意义。方法用免疫组化法检测78例原发乳腺癌组织中P-gp、GST-π及TopoⅡ的表达水平。结果(1)78例乳腺癌组织中P-gp、GST-π和TopoⅡ表达率分别为28.2%、38.5%和52.8%。(2)P-gp和GST-π表达与年龄、肿瘤大小、淋巴结转移、远处转移、临床分期、组织学类型无显著差异(P>0.05),TopoⅡ表达与肿瘤大小、远处转移、临床分期、组织学类型无显著差异(P>0.05),但与年龄、淋巴结转移有显著差异(P<0.05)。P-gp和GST-π的表达呈正相关(P<0.05),P-gp和TopoⅡ的表达呈明显负相关(P<0.05),GST-π和TopoⅡ呈明显负相关(P<0.05)。结论(1)部分乳腺癌患者体内原发存在耐药基因,对抗癌药物已产生耐药性。(2)乳腺癌化疗前检测耐药基因P-gp、GST-π与TopoⅡ,对肿瘤的化疗药物选择具有指导作用,对判断预后及研究耐药逆转提供参考价值。

Objecitive To explore the expression and clinical significance of P-glycoproteim（P-gp）, Glutathione-s-transferase-π（GST-π） and Topo Ⅱ in breast carcinoma tissue.Methods The expression level of P-gp,GST-πand Topo Ⅱ in the operating samples from 78 cases with untreated primary breast carcinomas were detected by immunohistochemical method. Results Positive expression rates of P-gp, GST-π and Topo Ⅱ in 78 cases of breast carcinoma were 28.2%,38.5% and 52.8% respectively.The positive expression of P-gp and GST-π was no relationship with patien＇s age,tumor size,lymph node metasis,distance metasis,clinical stage and histological type（P〉0.05）,and Topo Ⅱ was significantly associated with patient＇s age and lymph node metasis （P〈0.05）.P-gp was positive correlation with GST-π（P〈0.05）,P-gp negatively related to Topo 11 （P〈0.05）. GST-π had obviously negative correlation with Topo 11 （P〈0.05）. Conclusion Partial patients with breast carcinomas had resistance drug gene naturally; before chemotherapy of patients with breast carcinoma,the test of resistance drug gene protein will help doctors select the mechanisms of drug and evaluate prognosis of breast carcinoma and muhidrug resistance reversion.