P-gp、MMP-2、C-erbB-2在乳腺癌原发灶和转移淋巴结中的表达对比研究

目的：探讨乳腺癌侵袭转移和多药耐药之间的关系,为治疗方案的个体化提供依据。方法：采用免疫组化方法检测46例乳腺浸润性导管癌患者乳腺原发灶及相应腋淋巴结转移灶中P-gp、MMP-2、c-erbB-2的表达,结合临床表现、病理学指标,分析其相关性。结果：46例原发灶P-gp阳性表达35例（76.1%）,MMP-2阳性表达25例（54.3%）,c-erbB-2高表达18例（39.1%）;相应腋淋巴结转移灶P-gp阳性表达28例（60.9%）,MMP-2阳性表达16例（34.8%）,c-erbB-2高表达16例（34.8%）;P-gp、MMP-2蛋白表达水平与肿块大小、淋巴结转移数目均呈正相关（P〈0.05）,c-erbB-2蛋白表达水平与腋窝淋巴结转移数量呈正相关,与ER、PR表达呈负相关,P-gp阳性表达与MMP-2和c-erbB-2的表达呈正相关（P〈0.05）。结论：肿瘤原发灶与转移灶存在异质性,P-gp、MMP-2、c-erbB-2的表达与乳腺癌的多药耐药和侵袭转移有关,检测上述基因在原发灶与转移灶的表达,为乳腺癌选择个体化的化疗、内分泌治疗及分子靶向治疗提供了分子生物学依据。

Expression and clinical significance of P-gp,MMP-2 and c-erbB-2 in infiltrating ductal breast cancer and metastatic axillary lymph nodes

Objective： To observe the expression of P-gp,MMP-2 and c-erbB-2 in primary tumor and their metastatic axillary lymph nodes and study the relationship with clinicopathology characteristics and also the correlation between P-gp,MMP-2 and c-erbB-2.Methods： Immunohistochemical technique was performed to detect the expression of P-gp,MMP-2 and c-erbB-2 in 46 cases of infiltrating ductal breast cancer with primary tumor and their metastatic axillary lymph nodes without undergoing neo-adjuvent therapy.Their clinical and pathological indices and follow up data were analyzed.Results： The positive rate of P-gp in primary tumor was 76.1%（35/46）and in metastatic axillary lymph nodes was 60.9%（28/46）,the expression of Pg-p was significantly correlated with the tumor size and lymph node metastasis（P 0.05）.The positive rate of MMP-2 in primary tumor was 54.3%（25/46）and in metastatic axillary lymph nodes was 34.8%（16/46）,the expression of MMP-2 was significantly correlated with the tumor size and lymph node metastasis（P 0.05）.The overexpression rate of c-erbB-2 in primary tumor was 39.1%（18/46） and in metastatic axillary lymph nodes was 34.8%（16/46）,The expression of c-erbB-2 was significantly correlated with the expression of ER and PR and lymph node metastasis（P 0.05）,but not with the age and the tumor size（P 0.05）.11,12 and 13 of 46 cases showed a discordance of MMP-2,P-gp and c-erbB-2 status between primary carcinoma and synchronous lymph node metastases.Conclusions： P-gp,MMP-2 and c-erbB-2 was correlated with the multidrug resistance and metastatic behavior in breast cancer,to detect the expression of the three genes may be helpful in choosing the treatment of breast cancer with chemotherapy endocrine therapy and gene therapy.