110例肺癌疗前MRP检测的临床意义

Clinical Significance of Detecting MRP in 110 Patients withLung Cancer

目的：检测１１０ 例疗前肺癌标本多药耐药相关蛋白（ ＭＲＰ） 的表达与预后的关系。方法：采用免疫组化法。结果：ＭＲＰ 总检出率６３ ．６ ％ （７０／１１０） ，ＳＣＬＣ、ＮＳＣＬＣ 分别为４６ ．７ ％ （７／８） 和６５ ．３ ％ （６２／９５） 。尽管鳞癌ＭＲＰ 的表达（７２ ．４ ％ ） 略高于腺癌（５８ ．３ ％ ） ， 但ＭＲＰ 的表达与病理类型、ＴＮＭ 分期及鳞癌、腺癌的分化程度无关。９０ 例接受化疗，７３ 例ＮＳＣＬＣ 中ＭＲＰ（ － ） 者及ＭＲＰ（ ＋ ～＋ ＋ ） 者中位生存期分别为１８ ．９ 个月和１２ ．６ 个月，Ｌｏｇ － Ｒａｎｋ ｔｅｓｔ 及Ｋａｐｌａｎ － Ｍｅｉｅｒ 生存曲线均示ＭＲＰ（ － ） 者较ＭＲＰ（ ＋ ～＋ ＋ ） 者有生存期优势（ Ｐ＜ ０ ．０２） ；３４ 例鳞癌中，ＭＲＰ（ － ）者生存率明显高于ＭＲＰ（ ＋ ～＋ ＋ ） 者。但ＭＲＰ 表达与腺癌预后无关。结论：ＭＲＰ 可能为鳞癌的负性预后因子。

Objective: To determine the clinical significance of multidrug resistance-associated protein (MRP) expression in lung cancer. Methods: Cancer tissues of 110 cases of lung cancer not yet treated lung cancer were examined by immunohistochemistry. Results: The overall MRP expression was 63.6%(70/110) as well as 46.7%and 65.3%in SCLC and NSCLC respectively. Although MRP expression in squamous cell carcinoma (Sq) (72.4%) was relatively higher than that in adenocarcinoma (Ad) (58.3%). The MRP expression was neither related with histological types nor with TNM stages and differentiation of Sq or Ad. The median survival duration (MSD) in patients with MRP(-) and MRP(+～++) were 18.9 months and 12.6 months respectively. The Kaplan-Meier′s curves and Log-Rank test (χ2=5.660 6 P< 0.02) showed that the survival of patients with MRP(+～++) was much lower than that of MRP(-). The patients with Sq expressed MRP(+～++) also showed worse prognosis than those with MRP(-). However, MRP expression did not have prognostic significance for Ad. Conclusion: The results suggest that MRP expression may be a poor prognostic factor for Sq.