多耐药基因在乳腺癌组织中的表达及价值

The Expression and Clinical Significance of Multidrug Resistance Gene in Breast Cancer Tissues

目的:观察多药耐药基因(MDR1)及其编码的糖蛋白(P-gp)在乳腺癌组织中的表达及临床价值。方法:选取病历资料完整的乳腺癌根治术乳腺组织标本84份,使用S-P法免疫组化法染色检测P-gp、谷光甘肽S转移酶(GST-π)及热休克蛋白(HSP70)、p53的表达情况,采用Kendall's taub相关性分析P-gp、p53、GST-π、及HSP70、p53之间协同表达关系。结果:P-gp表达阳性率为50%(42/84),HSP70表达阳性率为61.9%(52/84),p53表达阳性率为52.4%(44/84),GST-π表达阳性率为40.5%(34/84);相关性分析显示,GST-π与P-gp无协同表达(r=0.146,P>0.05),HSP70与p53有协同表达(r=0.626,P<0.05),p53与P-gp有协同表达(r=0.763,P<0.05);P-gp表达对对乳腺癌10年生存率有明显影响。COX模型乳腺癌预后多因素分析表明,年龄因素、GST-π表达均不具有独立的预后意义;临床分期、组织学分级、P-gp表达、p53表达、HSP70表达均具有独立的预后意义。结论:同时检测MDR1、HSP7、p53和GST-π的表达,可为乳腺癌临床耐药性的判断提供更为全面的信息。

Objective： To observe the expression of multidrug resistance gene（ MDR1） and its encoding glycoprotein（ P-gp） and clinical value in breast cancer. Methods： Selected the complete medical records of breast cancer radical mastectomy of breast tissue specimens of 84 copies,using S-P method of immunohistochemical staining to detect P-gp,GST-π and heat shock protein（ HSP70）,the expression of p53,using the Kendall＇s Taub correlation analysis between P-gp,p53,GST-π,and HSP70,a PI the relationship between the expression of p53. Result： The positive rate of P-gp expression was 50%（ 42 / 84）,the positive rate of HSP70 expression was 61.9%（ 52 / 84）,the positive rate of p53 expression was 52.4%（ 44 / 84）,GST-class expression positive rate was 40.5%（ 34 / 84）; correlation analysis showed that GST-π and P-gp,PI no synergistic expression（ r = 0.146,P〉0.05）,HSP70 and p53 have synergistic expression（ r = 0.626,P〈0.05）,p53 and P-gp have synergistic expression（ r = 0.763,P〈0.05）; the expression of P-gp of breast cancer 10 years survival rate has obvious effect. Multivariate prognostic models of human breast cancer COX analysis showed that the factors of age,GST-π,PI expression do not have independent prognostic significance; clinical staging,tissue have independent prognostic significance grading,P- gp expression,p53 expression,HSP70 expression. Conclusion： At the same time,the expression of MDR1,HSP7,p53 and GST-π,for clinical drug resistance of breast cancer judgment to provide more comprehensive information.