肿瘤耐药相关标志物在乳腺癌中的表达及与预后的关系

The prognostic significance of drug-resistance genes associated marker expression in breast cancer

目的:检测乳腺癌组织中耐药蛋白P-gp、BCRP及LRP的表达,探讨其在乳腺癌复发转移及预后中的作用。方法:采用免疫组织化学方法检测126例乳腺癌组织、42例癌旁组织中P-gp、BCRP及LRP的表达。结果:①乳腺癌组织中P-gp、BCRP及LRP阳性表达率分别为41.26%、38.89%和65.87%,明显高于癌旁组织中的表达(14.28%,16.67%和19.05%),差异有统计学意义(P<0.05);②乳腺癌组织中有2个耐药蛋白共表达率为54.50%;2个或3个耐药蛋白共表达率为65.17%,明显高于单独耐药蛋白阳性表达率23.59%,5年总生存率分别为41.38%及41.67%低于单个或三者均阴性耐药蛋白表达者(84.62%、88.89%),差异有统计学意义(P<0.05)。③P-gp阳性表达者5年复发转移率为58.97%,高于P-gp阴性表达者(P<0.01)。结论:乳腺癌组织中耐药是单个耐药蛋白和多个耐药蛋白协同作用,以多个耐药蛋白共表达为主,联合检测耐药蛋白可预测乳腺癌的复发转移及预后。

Objective：To investigate the expression of the P-gp, BCRP and LRP in human breast cancer tissues and paratumor tissues.To evaluate the role of P-gp, BCRP and LRP in breast cancer recurrence, metastasis and prognosis. Methods：To exam the expression level of P-gp, BCRP and LRP in 126 case breast cancer tissues and 42 case paratumor tissues by immunohistochemistry（IHC）. Results：①The positive expression rate of P-gp, BCRP and LRP were 41.26%、38.89% and 65.87%;The positive expression rate of breast cancer tissues were much higher than those in paratumor tissues, their were significantly difference（P0.05）;②The coexpression rate of only 2 multi-protein and 3 multi-protein were 54.50% and 65.17%, which exceeded apparently more than individual expression rate of 25.00%; The 5-year survival rate of 2 multi-protein and 3 multi-protein positive cases （41.38% and 41.67%） were significantly lower than that of a single protein expression and three negative cases （88.89% and 84.62%） （P0.05）.③The 5-year recurrence, metastasis of P-gp negative cases （18.75%） was significantly lower than that in positive cases （58.97%） （P0.05）. Conclusion：Breast cancer resistance is single protein cooperated with multi-proteins, but the coexpression of multi-proteins are most important. Combined drug-resistance-associated markers may help judge recurrence, metastasis and prognosis of patients with breast cancer.