原发性双侧乳腺癌P-gp LRP的表达及其与预后相关性的研究

目的：探讨P-糖蛋白（P-gp）、肺耐药蛋白（LRP）在双侧乳腺癌中的表达特点及其预后意义.方法：收集我院1989～2000年收治的原发性双侧乳腺癌45例,同时随机选取单侧乳腺癌病例41例作为对照.应用免疫组化方法（S-P法）检测P-gp与LRP在双侧乳腺癌第一癌、第二癌及单侧乳腺癌中的表达.结果：1）双侧乳腺癌第一癌、第二癌及单侧乳腺癌中P-gp表达率分别为66.7%、46.7%、26.8%.显示双乳癌第一癌比单侧乳腺癌P-gp表达率高,差异有显著性（P＜0.01）.双乳癌第一癌、第二癌及单乳癌中LRP表达率分别77.8%、75.6%、52.3%,显示双侧乳腺癌第一癌及第二癌比单侧乳腺癌LRP表达率高,差异有显著性（P＜0.05）.2）P-gp、LRP表达与双乳癌原发肿瘤大小、组织学分级、病理类型无关,与临床分期有关.LRP与双侧乳腺癌淋巴结转移情况有关.3）双侧乳腺癌第二癌P-gp的表达情况与复发转移情况有关,P-gp、LRP的不同表达状态与双乳癌生存率的差异无统计学意义.结论：P-gp、LRP可能与双侧乳腺癌发病有关,它们有可能成为遴选双侧乳腺癌高危患者的蛋白检测指标和预后因子.

Expression of P-gp and LRP and its Relation to Prognosis of Bilateral Primary Breast Cancer

Objective:To detect expression of P-gp and LRP and to determine if a correlation exists between these expression levels and the prognosis of bilateral primary breast cancer (BPBC). Methods:The expression levels of P-gp and LRP were studied in 45 cases with BPBC and 41 cases with unilateral primary breast cancer (UPBC) using immunohistochemistry, and the relationship between the expression of these two proteins and survival time of the patients with BPBC was analyzed. Results:The difference in P-gp overexpression between the patients with the first tumor of BPBC and the UPBC was statistically significant (P<0.05). The difference in LRP overexpression between the patients with first tumor of BPBC and the UPBC was also statistically significant (P<0.05). There was no correlation between the expression of P-gp and LRP and the histological grade, tumor size or pathological type, but there was a correlation between the expression and clinical stage of BPBC. There was also a relationship between the expression of P-gp in the second tumor of BPBC and the relapse and metastasis of the BPBC, but there was no relationship between various expression patterns of P-gp and LRP and survival time of BPBC. Conclusion:P-gp and LRP might be related to pathogenesis of BPBC and may become a prognostic factor and for high-risk BPBC.