多药耐药基因蛋白与乳腺癌临床病理观察

目的：检测乳腺癌组织中多种耐药相关基因和三阴乳腺癌表达差别，进一步了解三阴乳腺癌的耐药特性，为临床治疗三阴乳腺癌选择化疗方案提供依据，评价其能否作为乳腺癌预后的分子生物学指标。方法选取术前未行化疗及内分泌治疗的31例乳腺癌标本，其中三阴乳腺癌病10例。采用免疫组化方法检测LRP，MDR-1，谷胱甘肽S转移酶（GSTπ），TopoⅡα在乳腺癌和三阴乳腺癌中的表达差别。结果 MDR-1，LRP，GSTπ，TopoⅡα4种耐药基因相关蛋白在所有乳腺癌病例中阳性表达率分别为40．95％，58．37％，59．31％，62．45％；MDR-1，LRP，GSTπ，TopoⅡα在非三阴组与三阴组阳性表达率分别为40．20％，47．61％，58．62％，57．14％和44．98．％，74．95％，60．00％，74．87％，其中GSTπ在两组中的表达差异有统计学意义（ P＜0．05）。两组乳腺癌中多基因共表达率分别为39．95％，10．99％差异有统计学意义（P＜0．05）。结论初治乳腺癌中存在多个耐药基因蛋白表达及共表达，三阴乳腺癌比非三阴乳腺癌化疗耐药性强，化疗效果不如非三阴组敏感。 GSTπ表达强于非三阴组，提示三阴乳腺癌预后较差，化疗不敏感。

The Clinicopathological Study of Multidrug Resistance Gene Proteins in Patients with Breast Carcinoma

Objective To investigate the different expression of several different types of drug resistance associated protein between breast carcinoma and triple negative breast carcinoma and to explore the characteristics of drug resistance protein of triple negative breast carcinoma .Methods Thirty-one cases of subjects suffering from breast cancer without preoperative chemotherapy and endocrine therapy were enrolled ,including 10 cases of three negative breast cancer.Immunohistochemical method was used to detect the LRP , MDR-1, glutathione Stransferase （ GSTπ）, TopoⅡαin breast cancer and three negative breast cancer patients .Results The positive expression rates of MDR-1,LRP,GSTπ, Topo IIαfour kinds of resistance related protein in all cases of breast cancer were 40.95%,58.37%,59.31%,62. 45%,and the positive expression rates of MDR-1,LRP,GSTπ,Topo IIαin non three negative group and the three negative group were 40.20%,47.61%,58.62%,57.14% and 44.98.%,74.95%,60.00%,74.87% respectively and GSTπshowed statistically differences in the 2 group （ P〈0 .05 ） .The coexpression rates of multiple genes in 2 groups were 39.95%and 10.99%,and the difference was statistically significant （P〈0.05）.Conclusion The early treatment of breast cancer notes the presence of multiple drug resistance gene expression and co expression .The drug resistance is stronger in three negative breast cancer ,and the effect of chemotherapy was non sensitive .The expression of GSTπin triple negative breast carcinoma was stronger than that in non triple negative breast carcinoma , suggesting that the three negative breast cancer prognosis is poorer ,not sensitive to chemothe .