乳腺癌组织P-糖蛋白的表达及其临床意义

目的研究Ｐ糖蛋白（Ｐｇｐ）在乳腺癌组织中的表达及其临床意义。方法用免疫组化法检测６０例乳腺癌、１９例转移性乳腺癌组织Ｐｇｐ表达及化疗疗效。结果乳腺癌Ｐｇｐ表达阳性率为４８．３％,Ｐｇｐ表达与年龄、月经状态、腋淋巴结转移数目、分期、病理组织类型及激素受体状况无关（Ｐ＞０．０５）。Ｐｇｐ阳性组远处转移率（６２．１％）及死亡率（５１．７％）高于阴性组（１６．１％及１２．９％,Ｐ＜０．００５）,５年生存率（４８．３％）低于阴性组（８７．１％,Ｐ＜０．０５）。阳性组辅助化疗后远处转移率（９４．７％）高于阴性组（５７．１％,Ｐ＝０．０４６８）。转移性乳腺癌Ｐｇｐ阳性组化疗有效率（１／１０）低于阴性组（７／９,Ｐ＝０．００５５）。结论免疫组化法检测Ｐｇｐ表达对评估乳腺癌多药耐药、化疗疗效及预后具有一定临床价值。Ｐｇｐ阳性者对ＭＤＲ型药物耐药,疗效及预后差。

Clinical significance of P-glycoprotein expression in breast cancer

OBJECTIVE: To study the clinical significance of P-glycoprotein (P-gp) in breast cancer. METHODS: Expression of P-gp in 60 cases of breast cancer was examined by immunohistochemistry. P-gp expression and response to chemotherapy were comparatively investigated in 19 patients with metastatic breast cancer. RESULTS: The P-gp was positive in 48.3% of the 60 cases of breast cancer. P-gp expression was not related to patients' age, menstruation status, number of axillary lymph nodes involved, clinical stage, histological type, and hormonal receptor status(P > 0.05). The frequency of metastasis (62.1%) and mortality (51.7%) were higher in P-gp positive cases than those in negative cases (16.1% vs 12.9%, P < 0.005). The 5-year survival rate of P-gp positive cases (48.3%) was significantly lower than that of negative cases (87.1%) (P < 0.05). In patients received adjuvant chemotherapy distant metastasis occurred more frequently in P-gp positive cases (94.7%) than in P-gp negative cases (57.1%) (P = 0.0468). More P-gp negative patients (7/9) than positive patients (1/10) were responsive to chemotherapy (P = 0.0055). CONCLUSION: Immunohistochemical examination of P-gp expression is useful in predicting response to chemotherapy and prognosis in breast cancer patients. P-gp positivity is associated with poor prognosis.