三种耐药基因蛋白表达在乳腺癌中的临床意义

Clinical Significance of Protein Expression of ThreeDrug Resistant Genes in Patients with Breast Cancer

目的:研究耐药基因P-糖蛋白Pgp、谷胱甘肽-S-转移酶π(GSTπ)和拓扑异构酶Ⅱα(TopoⅡα)蛋白表达在乳腺癌中的临床意义。方法:采用免疫组织化学法染色,应用流行病学统计方法分析实验结果及临床病例随访资料。结果:Pgp和TopoⅡα蛋白阳性表达与乳腺癌腋窝淋巴结转移和远处转移有关。Pgp和GSTπ阳性表达与术前化疗相关。单变量分析Pgp和GSTπ是乳腺癌总生存率的影响因素,但多变量分析未见相关性。结论:Pgp和TopoⅡα蛋白表达与乳腺癌转移呈密切相关,术前化疗可诱发乳腺癌耐药性发生,三种耐药基因蛋白均不能作为独立的预后指标。

Objective: To investigate clinical significance of drug resistant genes P glycoprotein(P gp), glutathoine S transferase Pi (GSTπ), and topoinsomerase Ⅱα (TopoⅡα) expression in the patients with breast cancer. Methods:P gp,GSTπ,and TopoⅡα protein expressions were determined using immunohistochemistry assay.The laboratory results and clinical follow up data were analyzed by epidemiological statistics. Results:P gp and TopoⅡα protein expressions were significantly associated with axially lymph node metastasis and distant metastasis. Both P gp and GSTπ positive expressions were related to preoperative chemotherapy. Univariate analysis showed that P gp and GSTπ expression could predict the overall survival(P=0.0001 and 0.0515, respectively), but no similar results were obtained by multivariate analysis. Conclusion:Both P gp and TopoⅡα expressions were closely related to breast cancer metastasis. Preoperative chemotherapy could induce drug resistance in breast cancer. But P gp, GSTπ, and TopoⅡα protein expressions cannot serve as an independent index for judging prognosis in breast cancer patients, respectively.