乳腺癌^(99m)锝-甲氧基异丁基异腈显像与三种多药耐药蛋白表达的关系

Study on relationship between ^(99m)Tc-MIBI scinigraphy of breast cancer and expression of multidrug-resistant protein

目的探讨乳腺癌对99mTc-甲氧基异丁基异腈(99mTc-MIBI)摄取、滞留与三种多药耐药蛋白表达的关系及临床意义。方法对60例未经治疗的乳腺癌患者静脉注射99mTc-MIBI740MBq进行早期(20min)和延迟(120min)平面显像,采用感性趣区(ROI)技术计算早期摄取比值(T/Ne)、延迟摄取比值(T/Nd)以及滞留率(RI%)。采用免疫组化方法检测空心针穿刺或手术乳腺癌组织多药耐药蛋白P-gp、MRP和GST-π表达水平,并与T/Ne、T/Nd和RI%进行相关性分析。结果99mTc-MIBI显像阳性率为93.33%;P-gp、MRP、GST-π表达的阳性率分别为73.21%、58.93%、51.79%,χ2=6.552,P>0.05三者无统计学意义。P-gp表达阳性组和阴性组RI%间有统计学意义(Z=-2.120,P<0.05)。P-gp表达与RI%呈负相关。结论99mTc-MIBI显像能预测乳腺癌组织P-gp的表达水平,为临床个体化治疗提供参考。

Objective To investigate the relationship between the degree of ^99mTc - methoxyisobutylisoni - trile （MIBI） uptake and expression of muhidrug - resistant protein P - gp, MRP and GST - π in patients with breast cancer. Methods 60 patients with untreated breast cancer were studied prospectively. After i. v administration of 740MBq ^99mTC -- MIBI, anterior planar scintigraphy was acquired at 20min and 120min after injection. Such indexes as early uptake radio, delay uptake radio and retention index （RI, % ） were calculated, respectively. Immunohistochemical analysis was used to evaluate the expression of P - gp, MRP and GST - π. Results The positive rate of ^99mTc - MIBI in the patient with breast cancer was 93.33% . The positive expression rates of P - gp, MRP and GST - were 73.21%, 58.93% and 51.79%. There was no significant difference among them. The RI % of P -gp positive group was significant lower than that of negative group. Conclusion The study suggests that ^99mTc - MIBI scintigraphy may predict the MDR development associated with P-gp expression in breast cancer, which can offer theoretical basis for individual therapy.