耐药蛋白P-gp、BCRP及LRP在乳腺癌原发灶和腋淋巴结转移灶中表达的比较  

Expressions of resistance proteins P-gp,BCRP and LRP:a comparison between primary and metastatic breast carcinoma

作　　者：刘新兰[1] 黄英[2] 李云霞[1] 段瑜[2] 

机构地区：[1]宁夏医科大学附属医院肿瘤内科,银川750004 [2]宁夏医科大学临床医学院肿瘤学系,银川750004

出　　处：《第二军医大学学报》2011年第11期1171-1175,共5页Academic Journal of Second Military Medical University

基　　金：宁夏高等学校科学研究项目(2006014)~~

摘　　要：目的研究P-糖蛋白(P-glycoprotein,P-gp)、乳腺癌耐药蛋白(breast cancer drug resistance protein,BCRP)和肺耐药蛋白(pulmonary resistance protein,LRP)在乳腺癌原发灶和腋淋巴结转移灶中表达的差异。方法采用免疫组织化学染色法检测126例乳腺癌患者的原发灶和66例腋淋巴结转移灶中P-gp、BCRP、LRP的表达。结果 (1)P-gp、BCRP及LRP在乳腺癌原发灶中的阳性表达率分别为41.27%(52/126)、38.89%(49/126)、65.87%(83/126),在腋淋巴结转移灶中阳性表达率分别为59.09%(39/66)、63.64%(42/66)、60.61%(40/66)。P-gp、BCRP在乳腺癌淋巴结转移灶中的表达高于原发灶(P<0.05),LRP在原发灶和淋巴结转移灶之间的表达差异无统计学意义。(2)P-gp、BCRP在乳腺癌原发灶和腋淋巴结转移灶中表达差异没有统计学意义(P<0.01),Kappa值分别为0.276、0.356;LRP在原发灶和淋巴结转移灶中的表达差异没有统计学意义(P>0.05)。(3)乳腺癌原发灶中2个耐药蛋白共表达率为35.71%(45/126),3个耐药蛋白同时表达的阳性率为15.08%(19/126),有2个或3个耐药蛋白共表达率为50.79%(64/126),高于单独阳性表达率33.33%(42/126,P<0.05)。腋淋巴结转移灶中2个耐药蛋白共表达率为53.03%(35/66),高于单独阳性表达率(27.27%[18/66],P<0.05);3个耐药蛋白同时表达的阳性率为16.67%(11/66),有2个或3个耐药蛋白共表达率为69.70%(46/66),高于单独阳性表达率(P<0.01)。腋淋巴结转移灶中2个耐药蛋白共表达率及2个或3个耐药蛋白共表达率均高于乳腺癌原发灶中的表达(P<0.05)。(4)Kaplan-Meier生存分析结果表明,乳腺癌腋淋巴结转移灶中P-gp、BCRP及LRP阳性表达者5年总生存期较原发灶耐药蛋白阳性者低(P<0.05)。结论在乳腺癌原发灶和腋淋巴结转移灶中的P-gp、BCRP表达差异有统计学意义,LRP表达则没有明显差异;多个耐药蛋白共表达协同作用为耐药的主要特征,腋淋巴结转移灶中可能具有更强的耐药性。Objective To investigate the differences in expressions of P-glycoprotein（P-gp）,breast cancer drug resistance protein（BCRP） and pulmonary resistance protein（LRP） between primary breast carcinoma and metastatic lymph nodes.Methods The expressions of P-gp,BCRP and LRP in breast cancer tissues,including 126 primary carcinoma and 66 metastasis lymph nodes,were determined immunohistochemically on formalin-fixed,paraffin-embedded tumor sections.Results（1）The positive expression rates of P-gp,BCRP and LRP were 41.27%（52/126）,38.89%（49/126）,and 65.87%（83/126） in primary breast carcinoma,and were 59.09%（39/66）,63.64%（42/66）,and 60.61%（40/66） in metastatic lymph nodes,respectively.The positive rates of P-gp and BCRP in the metastatic lymph nodes were significantly higher than those in primary cancer tissue（P0.05）;there was no significant difference in expression of LRP（P0.05）.（2） There was a poor consistency in P-gp and BCRP expression between the primary and metastatic sites（P0.01,Kappa value were 0.276 and 0.356）;there was a consistency in LRP expression between the primary and metastatic sites（P0.05）.（3） The co-expression rate of two resistance proteins in primary breast carcinoma was 35.71%（45/126）,of three resistance proteins was 15.08%（19/126）,and of two or three resistance proteins was 50.79%（64/126）,being significantly higher than that of a single protein 33.33%（42/126,P0.05）.The co-expression rate of two resistance proteins in metastasis lymph nodes was 53.03%（35/66）,which was significantly higher than that of a single protein 27.27%（18/66,P0.05）.The co-expression rate of three resistance proteins was 16.67%（11/66）,two or three resistance proteins was 69.70%（46/66）,which was significantly higher than that of a single protein（P0.01）.Both the co-expression levels of two resistance proteins and two or three resistance proteins in metastatic lymph nodes were significantly higher than those in primary cancer（P0.05）.�

关 键 词：乳腺肿瘤 腋淋巴结转移灶 P糖蛋白 乳腺癌耐药蛋白 肺耐药蛋白 

分 类 号：R737.9[医药卫生—肿瘤]