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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。
Objective: To investigate the relationship between invasion and metastasis of breast cancer and multi-drug resistance and to provide basis for the individualization of treatment regimen. Methods: The expressions of P-gp, MMP-2 and c-erbB-2 in 46 cases of breast invasive ductal carcinoma and their corresponding axillary lymph node metastases were detected by immunohistochemistry. Combined with clinical manifestations, , Analyze its relevance. Results: The positive expression of P-gp was found in 35 cases (76.1%) of 46 cases, 25 cases (54.3%) of MMP-2 positive and 18 cases (39.1%) of c-erbB- The positive expression of P-gp was found in 28 cases (60.9%), the positive expression of MMP-2 in 16 cases (34.8%) and the expression of c-erbB-2 in 16 cases (P <0.05). The expression of c-erbB-2 protein was positively correlated with the number of axillary lymph node metastasis and negatively correlated with the expression of ER and PR. The positive expression of P-gp was positively correlated with the expression of MMP-2 and c -erbB-2 expression was positively correlated (P <0.05). Conclusion: There is heterogeneity in primary tumor and metastasis. The expression of P-gp, MMP-2 and c-erbB-2 is correlated with multidrug resistance and invasion and metastasis of breast cancer. The expression of metastases provides a molecular basis for the individualized chemotherapy, endocrine therapy and molecular targeted therapy for breast cancer.