乳癌组织P16蛋白、MDR1、t-PA检测及其临床意义

Determination and Evaluation of P16 protein,MDR1 gene, T PA in patients with breast cancer

目的检测Ｐ１６蛋白、多药耐药基因（ＭＤＲ１）及组织纤溶酶原激活物（ｔ－ＰＡ）在乳腺浸润型导管癌组织中的表达及水平，并探讨三者与其他临床病理资料的关系，以便为乳癌的辅助治疗提供更多的信息。方法分别采用免疫组化ＡＢＣ法、ＲＴ－ＰＣＲ方法、化学底物发色法测定Ｐ１６蛋白、ＭＤＲ１、ｔ－ＰＡ值，统计患者的临床分期、病理分级、激素受体、月经状况等，并作相关性分析。结果Ｐ１６蛋白（８９例），阴性和低表达共６７例，阳性仅２２例，表达状况与肿瘤临床分期及病理分级无相关性；ＭＤＲ１（５５例），阳性表达１６例，阴性和低表达共３９例，耐药性在不同的临床分期及激素受体状况组中无差别；ｔ－ＰＡ值在乳癌组（ｎ＝６９）为９８±４７Ｉｕ／ｍｇ蛋白，略高于纤维瘤组（８７±４０，ｎ＝３３），无统计学差别，激素受体（ＥＲ、ＰＲ）双阳性组ｔ－ＰＡ值（１２５±３７）显著高于其他组，随临床分期Ⅰ→Ⅲ，ｔ－ＰＡ值呈显著下降趋势（Ｐ＜０．０１）。结论乳癌组织存在较大比例的Ｐ１６蛋白丢失和低表达（７５．２８％），一定比例的ＭＤＲ１高表达（２９．１％），ｔ－ＰＡ值可作为激素受体的补充说明，并提示临床病程。

Objective To detect the expression of P16 protein and multidrug resistance(MDR1) gene,the level of tissue type plasminogen activator (t PA) in breast cancer tissue,and investigate their value in adjuvant therapy for the breast cancer.Methods p16 protein,MDR1 gene,T PA were measured by means of ABC immunohistochemical technique,RT PCR technique and substrate colorimetry method respectively.The relations between these three markers and other clinico pathological data were studied in order to furnish additional information for adjuvant therapy of the breast cancer.Results The results showed that the positive expression of p16 protein appeared in 22/89 cases,of MDR1 appeared in 16/55 cases.The expression of p16 protein had no relation to the clinical stage and the histological grade,and the MDR1 expression is unrelated to ER,PR expression and clinical stage.The level of t PA was 98±47iu/mg protein in 69 patients with breast cancer and 87±40iu/mg protein in 33 patients with breast fibroma,and were no different in both groups.Statistical investigation showed that t PA level was significantly increased with ER + PR + of breast cancer (125±37).t PA level was decreasing as the clinical stage being from Ⅰ to Ⅲ (p< 0.01 ).Conclusions In breast cancers, The lost and lower expression rate of p16 protein is 75.28% (67/89).The positive expression rate of MDR1 is 29.1% (16/55).t PA level can reflect the functional status of steroid receptor and clinical stage.