骨肉瘤组织中P-gp及LRP的表达与临床病理特点关系的研究

The expression of P-gp and LRP and its relative clinical pathological in human osteosarcoma

目的研究P 糖蛋白 (P gp)及肺耐药相关蛋白 (LRP)在骨肉瘤 (OS)中的表达及与临床病理特点的关系。方法 38例OS及 10例正常骨组织的石蜡切片 ,以P gp单克隆抗体C2 19及LRP单克隆抗体LRP56用SABC法进行免疫组化染色 ,并对有关临床及病理指标综合分析。结果OS中P gp及LRP阳性表达率分别为 5 5 2 6 %和 42 11% ,而正常骨组织均为阴性表达 ,两组间比较差异有显著意义(P <0 0 5 )。此外 ,P gp在转移组及外科分期较高组中的表达率高于未转移组及外科分期较低的病例组 (P <0 0 5 ) ;LRP在 <12岁或 >30岁年龄组中明显高于 12～ 30岁病例组 (P <0 0 5 )。结论 (1)P gp与LRP均介导OS的多药耐药 (MDR)。 (2 )人OS对化疗不敏感、预后差与OS组织中存在P gp及LRP有关。 (3)P gp与LRP的表达不相关 ,分别以独立机制介导OS的MDR。 (4 )用免疫组化法检测OS的P gp和LRP ,可作为临床常规筛选检测 ,并为指导制定合理的治疗方案和预后评估提供依据。

Objective To study the expression of the P-glycoprotein (P gp)and Lung resistance related protein (LRP) in human osteosarcoma (OS) and their relationship with the clinical and pathological features. Methods P gp monoclonal antibody C 219 and LRP monoclonal antibody LRP 56 were used to examine the expression of P gp and LRP in paraffin section of 38 human OS, and 10 normal human bone tissues by immunohistochemical stain protocal=SABC.The correlation with patients clinical manifestations and histopathological characteristics were analyzed. Results The positive expression rates of P gp and LRP were 55.26% and 42.11% respectively in OS. In normal bone tissues P gp and LRP were negative; Statistically the difference between OS and normal bone tissues was significant( P <0.05); Additionally the positive expression rates of P gp in patients with distant metastasis and higher surgical stage increased abviously in comparison with those cases of non metastasis and lower surgical stage( P <0.05); The poitive expression of LRP in patients in age group <12 years or>30 years increased abviously( P <0.05).Conclusions 1.MDR of OS is mediated by P gp and LRP. 2.The unsusceptivity to chemotherapy and poor prognosis of human OS had correlation with the expression of P gp and LRP in OS. 3. The expression of P gp is not associated sith that of LRP. They both mediated the MDR of OS by its own independent mechanism.4. Immunohistochemical method is suitable for clinic detection for the expression of P gp and LRP in OS , and it is benefit in guiding treatment and evaluating prognosis in OS.