多药耐药基因产物和激素受体在乳腺癌中的表达及意义

目的：探讨多药耐药基因产物谷胱甘肽转移酶π（ GST-π）、肺耐药相关蛋白（ LRP）和DNA拓扑异构酶Ⅱ（ TopoⅡ）和雌激素受体（ ER）、孕激素受体（ PR）在乳腺浸润性导管癌组织中的表达及临床意义，并分析多药耐药基因产物与雌、孕激素受体之间是否有关联。方法应用免疫组织化学SP二步法检测194例乳腺浸润性导管癌组织中GST-π、LRP、TopoⅡ、ER、PR的表达，且结合乳腺癌临床病理因素进行分析。结果194例乳腺浸润性导管癌组织中GST-π、LRP、TopoⅡ表达的阳性率分别为62.4％、81.4％、51.5％。 LRP和TopoⅡ在伴有淋巴结转移的乳腺浸润性导管癌患者中的表达高于无淋巴结转移者（ P＜0.05），而与患者年龄、肿块长径、组织学分级、TNM分期等临床病理因素之间无相关性（P＞0.05）；LRP和TopoⅡ的表达与ER、PR的表达均无明显相关性（ P＞0.05）。 GST-π的表达与ER、PR的表达呈负相关（ P＜0.05），而与其它临床病理因素之间未见相关性（ P＞0.05）。 LRP、GST-π、TopoⅡ两两之间无相关性（ P＞0.05）。结论 GST-π、LRP、TopoⅡ与乳腺浸润性导管癌的多药耐药有关，且LRP和TopoⅡ与乳腺癌的转移有一定关系，GST-π与ER、PR负性相关。联合检测可为乳腺癌的临床化疗药物选择及评估预后提供依据。

Expression and clinical significance of multidrug resistance gene products and hormone receptor in breast carcinoma

Objective To explore the expression and clinical significance of multidrug resistance gene products glutathione -S-trans-ferase-π（GST-π） , lung resistance protein （LRP）,topoisomeraseⅡ（TopoⅡ）, estrogen receptor（ER） and progesterone receptor （ PR） in breast invasive ductal carcinoma tissues ,and analyze whether there is a connection between multi-drug resistant gene product and hormone recepor .Methods Expression of LRP ,GST-π,TopoⅡ,ER and PR was examined in the tissue sections from 194 cases of human breast invasive ductal carcinoma using streptoavidin-biotin-peroxidase immunohistochemistry method ,and analyse their correla-tion to clinicopathological characteristics of breast carcinoma .Results Positive rate of GST-π,LRP and TopoⅡ expression in breast invasive ductal carcinoma tissues was 62.4%, 81.4%and 51.5%, respectively .Expression of LRP and TopoⅡ was higher in lymph node metastasis group than that in non-lymph node metastasis group （P＆lt;0.05）,and it was not related to age of patients , tumor longest diameter, tumor grade,TNM stage,ER and PR.Expression of GST-πwas negtively related to ER and PR （P＆lt;0.05）,and it was not related to other clinico pathological characteristics .There is not related to between LRP ,GST-πand TopoⅡ（P＆gt;0.05）.Conclusions Expression of LRP ,GST-πand TopoⅡis related to multidrug resistance of breast invasive ductal carcinoma .LRP and TopoⅡis re-lated to the invasion and metastasis of breast cancer .GST-πwas negtively related to ER and PR .Choosing the chemotherapeutics and assessing prognosis are on the basis of the joint detection of LRP ,GST-πand TopoⅡ.