膀胱癌组织中P-糖蛋白、多药耐药相关蛋白、Bad的表达及其与临床病理的关系

目的：探讨膀胱癌组织中P-糖蛋白（P-gp）、多药耐药相关蛋白（MRP）和凋亡蛋白Bad的表达及其与临床病理之间的关系。方法：采用SP法检测67例膀胱癌组织及20例正常膀胱组织中P-gp、MRP和Bad的表达情况。结果：67例膀胱癌患者中P-gp、MRP和Bad的阳性率分别为65.7%（44/67）、58.2%（39/67）和62.7%（42/67）,而在正常膀胱粘膜中分别为10.0%（2/20）、5.0%（1/20）和5.0%（1/20）,二者比较均有统计学差异（P〈0.05）;35例初发膀胱癌组织中,P-gp、MRP和Bad阳性表达率分别为45.7%、48.6%、71.4%,与32例复发膀胱癌组织中的87.5%、68.8%、51.3%比较,亦均有显著性差异（P〈0.05）。P-gp与MRP表达无明显相关性（P〉0.05）。膀胱癌细胞分化程度越低,临床分期越高,P-gp阳性率越高（P〈0.05）,Bad表达越低,呈负相关关系。MRP与临床分期、组织分级无相关性。结论：P-gp过表达、Bad低表达在膀胱癌复发中可能具有一定的协同作用。

Expression of P-glycoprotein, multidrug resistance protein and Bad in bladder carcinoma and its relation to clinicopathology

Objective:To study the expression of P-glycoprotein(P-gp),multidrug resistance protein(MRP)and Bad in transitional cell carcinoma of bladder(TCC)and normal bladder mucosa and its relation to clinicopathology.Methods:S-P immnohistochemical staining was performed to evaluate the positivity of P-gp,MRP and Bad in 67 cases of TCC and 20 cases of normal bladder mucosa.Results:The positive rate of P-gp,MRP and Bad was 65.7%(44/67),58.2%(39/67)and 62.7%(42/67)in 67 cases of TCC,but 10.0%(2/20),5.0%(1/20)and 5.0%(1/20)in 20 normal bladder mucosa(P<0.05)respectively.Compared with the initial cases,the expression of P-gp had a higher level,and no relation with MRP,but the expression of Bad had a lower level in the relapse cases.The expression of P-gp and MRP had no correlation(P>0.05).But the expression of P-gp and Bad had negative correlation:The lower differentiation of the TCC,the higher grade of the clinical stage,the positive rate of the expression of P-gp was higher(P<0.05)and Bad was lower.The expression of MRP had no relation between the clinic stage and differentiation of TCC.Conclusion:The overexpression of the protein of P-gp and lower expression of Bad had relation to recurrence of bladder.