肺耐药蛋白在乳腺癌中的表达及临床意义

Expression and Clinical Significance of Lung Resistance Protein in Breast Cancer

目的研究乳腺癌组织中肺耐药蛋白(lung resistance protein,LRP)的表达,探讨其在乳腺癌多药耐药机制中的作用及其临床意义。方法2000年首都医科大学附属北京友谊医院普通外科收治的乳腺癌病例81例,均为女性,年龄30至83岁(平均年龄53.2岁),接受以手术为主的综合治疗且均未进行新辅助化疗。病理类型包括浸润性导管癌、浸润性小叶癌、单纯癌、黏液癌和早期浸润癌。根据2003版国际抗癌联盟(International Union Against Cancer,UICC)乳腺癌分期标准进行临床病理分期,Ⅰ期:17例,Ⅱ期:43例,Ⅲ期:21例。术后5年随访者36例,无瘤生存30例,转移6例(带瘤生存1例,死亡5例)。制作组织芯片,采用SP免疫组化染色法,测定81例未经过新辅助化疗的乳腺癌标本中LRP的表达,与临床病理因素及雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、抑癌基因p53(p53)、人表皮生长因子受体2(Her-2)、增生细胞核抗原Ki-67(Ki-67)的表达进行相关性分析。应用χ2检验及等级相关检验,使用SPSS11.5统计学软件进行数据处理及分析。结果乳腺癌组织中LRP的阳性表达率为70.4%(57/81)。老年患者的LRP表达比中青年患者明显降低(P<0.05);LRP的表达与病理分期、预后无相关关系(P>0.05)。LRP与ER和PR的表达存在一定的正相关关系,相关系数分别为0.327、0.264(P<0.05);LRP与p53、Her-2、和Ki-67的表达无相关关系(P>0.05)。结论LRP在乳腺癌组织中有较高的表达率,与年龄及ER、PR的表达有关,本结果为临床化疗药物的选择提供了依据。

Objective To investigate the expression of lung resistance protein（LRP） genes in breast cancer and to explore the role of multi-drug resistance mechanism in breast cancer and its clinical significance.Methods Totally 81 female cases of breast cancer,who were treated in the department of general surgery of Beijing Friendship Hospital in 2000,aged 30～83 years（average 53.2 years）,accepted the comprehensive treatment with surgery without neoadjuvant chemotherapy.Pathological types included invasive ductal carcinoma,invasive lobular carcinoma,the only cancer,mucus cancer and early invasive cancer.According to standards of International Union Against Cancer（UICC） 2003 version for clinicopathological staging of breast cancer,17 cases were at stage Ⅰ,43 cases stage Ⅱ,and 21 cases stage Ⅲ.Thirty-six cases had five-year follow-up results,30 cases had disease-free survival for 5 years,6 cases had metastasis（1 case survived with tumor and 5 cases died）.Tissue chips were prepared.LRP expression in breast cancer tissue was determined by using immunohistochemistry and in situ hybridization,and other detection technology.Results According to manual reagents criteria of Maixin company,the results were separated into negative（-/＋） and positive（＋＋/＋＋＋）.The positive rate of LRP in breast cancer was 70.4%（57/81）.The 81 cases were divided into two groups：young and middle-aged group（age〈50 years,36 cases） and elderly group（≥50 years,45 cases）.It was found that positive correlation was not only found between LRP and ER but also between LRP and PR.The correlation coefficient were 0.327,0.264,P〈0.05.But there was no correlation between LRP and p53,Her-2 and Ki-67,P〉 0.05.Conclusion The expression of LRP increased in breast cancer evidently,there was correlation between the LRP expression and age,expression of ER and PR,which may provide basis for selecting the drug of chemotherapy.