多药耐药蛋白在肝癌中的表达及临床意义

Expression of multidrug resistance protein in hepatocellular carcinoma and its clinical significance

目的探讨肝癌中多药耐药相关蛋白1（MRP1）、肺耐药蛋白（LRP）、P-糖蛋白（PgP）、胎盘型谷胱甘肽-s-转移酶π（GST-π）和拓扑异构酶Ⅱ（TOPOⅡ）的表达情况，为肝癌的化疗提供依据。方法选取肝癌手术切除标本26例，取肝癌组织和癌旁肝组织进行MRP1、LRP、Pgp、GST-π和TOPOⅡ检测，采用图像分析系统对结果进行分析。结果五种多药耐药蛋白在肝癌组织中表达量比癌旁肝组织中高，差异有统计学意义（P〈0．05）。Pgp、TOPOⅡ和GST-π在肝癌组织中表达量与肝外转移差异有统计学意义（P〈0．05）。五种多药耐药蛋白的阳性率在分化不良肝癌组织高于分化良好肝癌组织，但只有TOPOⅡ差异有统计学意义（P〈0．05）。五种多药耐药相关蛋白在肝癌组织中表达量与肿瘤直径、AFP水平、门静脉癌栓、肝硬化情况和肝功能分级之间差异无统计学意义（P〉0．05）。结论五种多药耐药蛋白在肝癌组织中均有不同程度的高表达，且与肿瘤某些生物学行为有关，联合检测有助于选择合理的化疗药物及判断预后。

Objective To investigate the expression of muhidrug resistance protein such as muhidrug resistance-associated protein 1 （MRP1）,lung-resistance related protein （LRP）, P-glycoprotein （Pgp）, glutathione s-transferase （GST- π ） and topoismerase Ⅱ （TOPO Ⅱ ） in hepatocellular carcinoma （HCC）, which would be supplied for the clinical chemotherapy of HCC. Methods Twenty-six cases of HCC who underwent hepatectomy were enrolled and immunohistochemical （IHC） staining was carried out on all specimens for the detection of expression of MRP1 ,LRP,Pgp,GST-πrand TOPO Ⅱ and the data was analyzed by image analysis system. Results The expression of five muhidrug resistance protein in HCC tissue were significantly higher than those in adjacent tissue beyond cancer （P 〈 0.05）. The significant differences were found in the expression of Pgp,TOPO Ⅱ and GST-π between HCC tissue and distant metastasis （P 〈 0.05 ）. The expression of the five muhidrug resistance protein in poorly differentiated HCC tissue was higher than that in well-differentiated tissue, while the significant difference was only found in the expression of TOPO Ⅱ （P〈 0.05）. The significant association was not found between the expressions of five muhidrug resistance protein in HCC tissue and the size of tumor,AFP, the portal vein tumor thrombus,hepatic cirrhosis and liver function. Conclusions Five multidrug resistance protein overexpression in various degrees in HCC tissue, which relates to some biological behavior of the cancer. Combined detection is of much benefit to the choice of the drug of chemotherapy and to the prediction of prognosis.