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目的 了解多药耐药相关类蛋白P gp、GST π、TOPOIIα和突变型 p53蛋白在乳腺癌化疗耐药机制中的作用及相互间关系。方法 用免疫组化SP法对 91例未经抗肿瘤治疗的原发性乳腺癌和 18例术后经化疗复治的乳腺癌组织中检测P gp、GST π、TOPOⅡα、p53蛋白表达。 结果 P gp在原发性乳腺癌中阳性率为 4 0 % ,术后经化疗复治的乳腺癌中阳性率为 6 1%。两组P gp阳性率和表达强度有显著性差异 (P =0 0 2 5)。GST π在原发性乳腺癌中阳性率为 75% ,癌旁正常和增生乳腺小叶相应地有程度不等的阳性表达。术后经化疗复治的乳腺癌中阳性率为 83% ,与原发性癌相比有增高趋势 ,但差异无显著性意义。GST π和P gp在乳腺癌组织共同表达且呈正相关 (P =0 0 2 8)。TOPOⅡα在原发性乳腺癌中阳性率为 4 2 % ,其中浸润性导管癌组阳性率为 4 8% ,而分化好的癌及导管内癌伴早浸的表达水平明显低 (P =0 0 2 7)。癌组织级别越高 ,TOPOⅡα表达水平也越高 (P <0 0 0 1) ,TOPOⅡα表达与肿瘤大小、临床分期有关 (P值分别为 0 0 4 0和 0 0 2 2 )。术后经化疗复治的乳腺癌中阳性率为17% ,与原发性癌相比显著降低 (P =0 0 4 5)。P gp、GST π与TOPOⅡα表达均无相关性 (P >0 0 5)。突变型 p53蛋白在原发性乳腺癌中阳性率为
Objective To investigate the roles and relationships of multidrug resistance-associated proteins P gp, GST π, TOPO II α and mutant p53 proteins in the mechanism of chemoresistance in breast cancer. Methods The expressions of P gp, GST π, TOPO Ⅱ α and p53 were detected by immunohistochemical SP method in 91 cases of primary breast cancer without anti-tumor therapy and 18 cases of postoperative chemotherapy-treated breast cancer. Results The positive rate of Pgp in primary breast cancer was 40%. The positive rate of Pgp in breast cancer after chemotherapy and chemotherapy was 61%. There was a significant difference between the two groups in the positive rate of P gp and the expression intensity (P = 0 0 2 5). The positive rate of GST π in primary breast cancer was 75%. There was a corresponding degree of positive expression of GST π between normal and hyperplastic breast lobes. Postoperative chemotherapy and re-treatment of breast cancer in the positive rate of 83%, compared with the primary cancer increased trend, but the difference was not significant. GST π and P gp expression in breast cancer tissues were positively correlated (P = 0.082). The positive rate of TOPOⅡα in primary breast cancer was 42%. The positive rate of TOPOⅡα in invasive ductal carcinoma was 48%, while that in differentiated carcinoma and intraductal carcinoma was significantly lower (P = 0 0 2 7). The higher the level of tumor tissue, the higher the expression level of TOPOⅡα (P <0.01). The expression of TOPOⅡα was related to tumor size and clinical stage (P = 0 0 40 0 and 0 0 2 2, respectively). Postoperative chemotherapy and re-treatment of breast cancer positive rate was 17%, significantly lower than the primary cancer (P = 0 0 455). There was no correlation between P gp, GST π and TOPOⅡα expression (P> 0.05). The positive rate of mutant p53 protein in primary breast cancer is