摘要
目的:探讨P-糖蛋白(P-glycoprotein,P-gp)和多药耐药相关蛋白(multidrugresistance-associatedprotein,MRP)在小儿神经母细胞瘤(neuroblastoma,NB)中的表达及临床意义。方法:应用SP免疫组织化学法检测70例NB组织中P-gp和MRP的表达。结果:P-gp和MRP的阳性率分别为61.4%(43/70)和38.6%(27/70)。P-gp与MRP共表达阳性率为32.9%(23/70)。P-gp与MRP具有相关性(r=0.387,P=0.001)。年龄>1岁的NBP-gp和MRP的表达阳性率(72.3%,48.9%)均高于<1岁者(39.1%,17.4%),(P<0.05)。分化性NBP-gp和MRP表达(93.3%和86.7%)均明显高于无分化的NB(52.7%和25.5%),(P<0.05)。有转移的NBMRP表达(61.9%)高于无转移者(28.6%),(P<0.05)。P-gp和MRP表达与性别和分期无关。年龄>1岁、有转移的NB、MRP阳性及P-gp与MRP共表达者中位生存期和2年累计生存率均降低,(P<0.05)。P-gp表达与生存期无关。多变量COX回归分析,年龄有预后意义(相对危险度、95%可信区间和P值分别为4.949、1.079～22.694和0.040)。结论:NB原发性耐药与P-gp和MRP共同作用有关,年龄、转移、MRP表达及P-gp与MRP共表达与NB预后有关。
Objective:To detect expression of p-glycoprotein(P-gp)and multidrug resis-tance-associated protein(MRP),and to evaluate its clinical significance in neuroblastoma (NB).Methods:SP immunohistochemical technique was used to investigate expression of P-gp and MRP in70cases of NB.Results:The frequency of expression of P-gp and MRP in NB was61.4%and38.6%,respectively.The coexpression rate of P-gp and MRP was32.9%.Significant positive correlation was observed between P-gp and MRP expression(r=0.387,P=0.001).The ex-pression of P-gp and MRP was higher in tumors from patients aged greater than1year compared with those aged less than1year at diagnosis(P=0.01,0.018,respectively).MRP expression was higher in tumors from the metastatic than the non metaststic(P=0.015).P-gp and MRP expression showed significant relationship to the differentiation of the tumor(P=0.006,0.000,respectively),but no correlation was found to the stage of NB or sex of the patients.Age greater than1year,metastasis,MRP expression and coexpression of P-gp and MRP was significant associated with re-duction in both median survival time and the two-year cumulative survival(P<0.05).In contrast,P-gp expression had no correlation with survival.By COX regression analysis,age of the patients retained significant prognostic value(relative hazard,4.949,P=0.040).Con clu sion:In NB,the intrinsic multidrug resistance involves the combined effects of P-gp and MRP;age,metastasis,MRP expression and coexpression of P-gp and MRP has prognostic significance.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2002年第12期850-854,共5页
Chinese Journal of Clinical Oncology
基金
国家自然科学基金资助(编号:39470739)
