几种多药耐药相关因子在肺癌中的表达及临床病理意义  

Expression and clinicopathological significance of several kinds of multidrug-resistance related factors in lung carcinoma

作　　者：孙志勇[1] 余宏宇[2] 刘会敏[2] 李玉莉[2] 何金[2] 孙静[2] 胡静姿[2] 杨志慧[2] 

机构地区：[1]成都军区总医院核医学科,成都610083 [2]第二军医大学附属长征医院病理科,上海200003

出　　处：《肿瘤》2007年第4期303-307,326,共6页Tumor

摘　　要：目的:探讨原发性肺癌中几种与多药耐药相关因子的表达及与临床病理的相关性。方法:采用免疫组化方法对术前未经化疗、术后病理诊断明确的133例肺癌组织标本和15例作为对照的癌旁肺组织(距肿瘤边缘5cm),进行了P-gp、MRP、LRP、p53及c-erbB-2蛋白表达的检测。结果:(1)133例肺癌组织中,P-gp、MRP、LRP、p53及c-erbB-2的阳性率分别为72.2%(96/133)、40.5%(51/126)、54.1%(72/126)、59.4%(79/126)和45.9%(61/133),除P-gp外均显著高于正常肺组织中的表达水平(P<0.05);且p53表达与P-gp及MRP表达之间(r=0.179及0.185,P=0.039及0.041),P-gp与LRP之间(r=0.264,P=0.002),LRP与MRP之间(r=0.309,P<0.001),以及c-erbB-2表达分别与MRP、LRP及p53表达之间(r分别为:0.350、0.421、0.541和0.354,P值均<0.001)均有相关性。(2)P-gp、MRP、LRP和c-erbB-2蛋白表达在不同病理类型之间具有统计学差异,而LRP蛋白表达在不同病理分化程度之间具有统计学差异(P<0.001),P-gp在鳞癌不同分化程度间表达有统计学差异(P=0.049)。(3)针对病理类型及亚型:①神经内分泌癌与非神经内分泌癌相比,后者的LRP和c-erbB-2蛋白表达水平较前者高(P=0.005和0.041);②未发现细支气管肺泡癌与其他类型腺癌间在MDR相关因子的蛋白表达水平上有统计学差异。结论:这些多药耐药相关因子可能均在肺癌的原发性多药耐药中起不同程度的作用,且在多药耐药形成以及肿瘤进展的过程中它们之间有某种程度的关联。Objective：To investigate the expression and clinicopathological significance of several kinds of muitidrug-resistance related factors in primary lung carcinoma. Methods：One hundred and thirty three cases of lung carcinoma tissues confirmed by pathological examination after surgery were included in the study and 15 cases of pericancerous tissues （5-cm apart from tumor） were selected as control. The expressions of P-gp （P-glycoprotein）, multidrug resistance-associated protein （MRP）, lung resistance-related protein （ LRP）, p.53, and c-erbB2 protein in paraffin-embedded tissues were detected by immunohistocbemistry. Results： （ 1 ） The positive rates of P-gp, MRP, LRP, p.53 and c-erbB2 in tumor tissues were 72.2% （96/133）, 40. 5% （51/126）, 54.1% （72/126）, 59.4% （79/126）, and 45.9% （ 61/133 ）, respectively, which were significantly higher than that in normal controls （ P 〈 0.05 ） except for the P-gp （P 〉0.05）. The expression of p.53 correlated with P-gp and MRP （r=0. 179 and0. 185, P =0.039 and 0.041）. There were significant correlation between P-gp and LRP （ r = 0.264, P = 0.002） as well as LRP and MRP （ r = 0. 309, P 〈 0.001 ）. The expres- sion of c-erbB-2 was associated with that of MRP, LRP, and p53 （ r = 0. 350, 0. 421,0. 541, and 0. 354, respectively; P 〈 0.001 ）. （2） There was significant difference among the different pathologic types in P-gp, MRP, LRP, and c-erbB-2 expression （P 〈0. 001 ）. The difference in P-gp expression was significant in lung squamous carcinoma at different differentiation degree （ P = 0.049）. （ 3 ） Ac- cording to pathological classification/sub-classification ： （1）The expression levels of LRP and c-erbB-2 were higher in the panel of neuroendocrine carcinoma than that in the panel of non neuroendocrine carcinoma （P =0. 005 and 0.041, respectively） ; （2）There was no significant difference in the expression of MDR-related factors between the panel of bronchioloalveolar carcinoma and

关 键 词：肺肿瘤 P糖蛋白 多药耐药相关蛋白质类 肿瘤抑制蛋白质P53 

分 类 号：R734.2[医药卫生—肿瘤]