乳腺癌^(99)Tc^m-MIBI显像与P-gp、MRP表达的关系  

The study of relationship between breast cancer ^(99)Tc^m-MIBI imaging with the expression of P-glycoprotein and multidrug resistance-associated protein

作　　者：林开文 刘保平[2] 程兵[2] 

机构地区：[1]许昌市中心医院核医学科,461000 [2]郑州大学第一附属医院核医学科

出　　处：《中华核医学杂志》2005年第5期288-290,i0003,共4页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨乳腺癌患者99Tcm-甲氧基异丁基异腈(MIBI)显像与癌组织中P-糖蛋白(P—gp)、多药耐药相关蛋白(MRP)表达的关系。方法对36例未经治疗的乳腺癌患者行99Tcm-MIBI早期(10 min)与晚期(180 min)平面显像,应用免疫组织化学方法检测手术后标本中P—gp、MRP的表达,并将患者分为4组:A组,P-gp和MRP均阳性(7例);B组,P-gp阳性和MRP阴性(15例);C组, P-gp阴性和MRP阳性(6例);D组,P-gp和MRP均阴性(8例)。比较各组早期和晚期肿瘤与对侧正常组织放射性比值(T/N)及肿瘤部位放射性清除率(WR)之间的差异。结果早期T/N A、B组均高于D组,差异有显著性(P值分别为0.001和0.045);晚期T/N各组间差异无显著性(P=0.686); 清除率A、B、C组均高于D组,差异有显著性(P值分别为<0.001、0.001和0.014)。结论99Tcm- MIBI显像清除率与乳腺癌P-gp、MRP表达呈正相关(r=0.839,P<0.001),99Tcm-MIBI显像清除率分析可用于乳腺癌P—gp。Objective To evaluate the relationship between the uptake, washout of ^99Tc^m-methoxyisobutylisonitrile （MIBI） and P-glycoprotein （P-gp） or muhidrug resistance-related protein （MRP） expression in 36 breast cancer patients. Methods 36 patients with untreated breast cancer were studied prospec- tively a week before surgical operation, all were injected intravenously with 740 MBq ^99Tc^m-MIBI in the arm contralateral to the lesion. Anterior planar images were acquired at 10 and 180 rain after injection and the tumor-to-normal breast ratios （T/N） and washout rates （WR） were calculated. Immunohistochemical analyses of P-gp and MRP expression were used to evaluate the removed tumor tissues after operation and categorized into four groups. The differences of the early T/N ratios, the late T/N ratios and the WR among them were compared. Results The early T/N ratios in group A and B were higher than that in group D. There was statistic difference between group A and D （P =0.001 ）, and also in group B and D （P = 0. 045 ）. The late T/N ratios had no statistic differences among them （ F = 0.499, P = 0.686）. The WR of group A, B, C were higher than that in group D and there were significant differences between them （ P 〈0. 001, P 〈0. 001, P 〈0.001 and P = 0. 014）. Conclusions A strong positive correlation was found between the WR of ^99Tc^m-MIBI from the lesions and expression of P-gp or MRP in untreated breast cancer patients. ^99Tc^m-MIBI imaging with washout analysis might be a useful method for evaluating P-gp or MRP overexpression and their function in breast cancer.

关 键 词：乳腺肿瘤 体层摄影术 发射型计算机 单光子 糖蛋白类 药物耐受性 MIBI ^99TC^M-MIBI显像 ^99TC^M-甲氧基异丁基异腈 乳腺癌患者 P-GP MRP 

分 类 号：R737.9[医药卫生—肿瘤] R735.2[医药卫生—临床医学]