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目的研究人肝细胞癌组织中多药耐药相关蛋白（ＭＲＰ）的表达情况并探讨其临床意义。方法采用免疫组织化学方法检测了１１０例随访资料完整的肝细胞癌石蜡切片组织中ＭＲＰ表达情况，并与临床病理指标联系，进行统计学分析。结果本组肝细胞癌１１０例，表达阳性５７例，其阳性率为５２％。术前行经肝动脉栓塞化疗（ＴＡＣＥ）及未行ＴＡＣＥ治疗者的ＭＲＰ阳性率分别为５１％（１９／３７）和５２％（３８／７３）。ＭＲＰ与癌灶大小、数目、癌栓、有无包膜、组织分化、乙型肝炎表面抗原（ＨＢｓＡｇ）情况、是否合并肝硬化无关。ＭＲＰ阳性患者的１、３、５年生存率分别为６３％、２６％和１０％；而ＭＲＰ阴性者的１、３、５年生存率分别为８９％、６０％和５３％，显著高于ＭＲＰ阳性者（Ｐ＜００１）。ＭＲＰ阳性者的无癌生存期平均为１１８个月，显著低于ＭＲＰ阴性者的３６２个月（Ｐ＜００１）。结论术前ＴＡＣＥ治疗与否不影响ＭＲＰ表达。ＭＲＰ的表达与ＨＣＣ预后呈显著负相关，可能成为判断ＨＣＣ预后的良好肿瘤标志物。
Objective To study the expression of multidrug resistance-associated protein (MRP) in human hepatocellular carcinoma and explore its clinical significance. Methods Immunohistochemistry was used to detect the expression of MRP in paraffin-embedded hepatocellular carcinoma tissues of 110 patients with complete follow-up data. The expression of MRP was correlated with clinical pathological parameters and statistical analysis was performed. Results In this group, 110 cases of hepatocellular carcinoma were positive and 57 cases were positive. The positive rate was 52%. The prevalence of MRP before transcatheter arterial chemoembolization (TACE) and without TACE was 51% (19/37) and 52% (38/73), respectively. MRP was not associated with tumor size, number, tumor thrombus, presence or absence of envelope, tissue differentiation, hepatitis B surface antigen (HB-sAg) status, and whether cirrhosis was associated. The 1-, 3-, and 5-year survival rates of MRP-positive patients were 63%, 26%, and 10%, respectively; while the 1-, 3-, and 5-year survival rates of MRP-negative patients were 89%, 60%, and 53%, respectively. MRP positive (P<001). The average cancer-free survival of MRP-positive patients was 11.8 months, which was significantly lower than that of MRP-negative patients (36 days and 2 months) (P < 0.01). Conclusion Preoperative TACE treatment does not affect the expression of MRP. The expression of MRP was significantly negatively correlated with the prognosis of HCC and may be a good tumor marker for the prognosis of HCC.